Provider Demographics
NPI:1467112060
Name:ONE ACCORD COUNSELING, LLC
Entity Type:Organization
Organization Name:ONE ACCORD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-399-8083
Mailing Address - Street 1:143 KELSNEY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8396
Mailing Address - Country:US
Mailing Address - Phone:803-920-9512
Mailing Address - Fax:803-759-8423
Practice Address - Street 1:143 KELSNEY RIDGE DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8396
Practice Address - Country:US
Practice Address - Phone:803-920-9512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty