| It's Your Move | |
|
425 Summit Terrace Ct Ste 7b Columbia SC 29229-7055 | |
| (877) 471-9865 | |
| (803) 335-5343 |
| Full Name | It's Your Move |
|---|---|
| Speciality | Clinic/Center |
| Location | 425 Summit Terrace Ct Ste 7b, Columbia, South Carolina |
| Authorized Official Name and Position | Deeneka Lachelle Beach-phelps (CEO) |
| Authorized Official Contact | 8774719865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| It's Your Move 425 Summit Terrace Ct Ste 7b Columbia SC 29229-7055 Ph: (877) 471-9865 | It's Your Move 425 Summit Terrace Ct Ste 7b Columbia SC 29229-7055 Ph: (877) 471-9865 |
| NPI Number | 1568114999 |
|---|---|
| Provider Enumeration Date | 01/26/2022 |
| Last Update Date | 01/26/2022 |
| Medicare PECOS PAC ID | 4880056837 |
|---|---|
| Medicare Enrollment ID | O20240318001623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568114999 | NPI | - | NPPES |
| GP8718 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lakesha Shingler Howell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609117100 PECOS PAC ID: 3971880675 Enrollment ID: I20190805000491 |
| Provider Name | Kenneth Martin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093899007 PECOS PAC ID: 4183076789 Enrollment ID: I20240318001765 |
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