Provider Demographics
NPI:1073987210
Name:COUNSELING SUMTER
Entity Type:Organization
Organization Name:COUNSELING SUMTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:803-720-9465
Mailing Address - Street 1:2645A HARDEE CV
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1893
Mailing Address - Country:US
Mailing Address - Phone:803-720-9465
Mailing Address - Fax:803-526-7067
Practice Address - Street 1:2645A HARDEE CV
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150
Practice Address - Country:US
Practice Address - Phone:803-720-9465
Practice Address - Fax:803-526-7067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-28
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC95221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty