Provider Demographics
NPI:1033763982
Name:SACRED HEART THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:SACRED HEART THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-346-8530
Mailing Address - Street 1:105 CHALLENGER CT
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2452
Mailing Address - Country:US
Mailing Address - Phone:864-346-8530
Mailing Address - Fax:800-340-0023
Practice Address - Street 1:501 W. BUTLER RD
Practice Address - Street 2:SUITE E
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-346-8530
Practice Address - Fax:864-751-5268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7185OtherPROFESSIONAL LICENSE- COUNSELOR