Provider Demographics
NPI:1093371528
Name:THERAPY YOUR WAY
Entity Type:Organization
Organization Name:THERAPY YOUR WAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANEICE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-A
Authorized Official - Phone:800-320-2943
Mailing Address - Street 1:PO BOX 7914
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-7914
Mailing Address - Country:US
Mailing Address - Phone:800-320-2943
Mailing Address - Fax:
Practice Address - Street 1:1320 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3266
Practice Address - Country:US
Practice Address - Phone:800-320-2943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty