Organization Name: | COUNSELING CENTER OF PENDELTON |
NPI Number: | 1235527326 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | COLLEEN D GOFF (OWNER) |
Mailing Address: | 104 Browns Square Dr Walhalla |
State: | SC US |
Postal Code: | 296912271 |
Phone Number: | 8648129400 |
Fax Number: | 8646442710 |
NPI Enumeration Date: | 12/26/2014 |
NPI Last Update Date: | 12/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4637 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |