Provider Demographics
NPI:1669031357
Name:MOUNTAIN VIEW THERAPY
Entity Type:Organization
Organization Name:MOUNTAIN VIEW THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MSP, CCC-SLP
Authorized Official - Phone:864-979-0219
Mailing Address - Street 1:PO BOX 6355
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29606-6355
Mailing Address - Country:US
Mailing Address - Phone:864-979-0219
Mailing Address - Fax:864-626-0466
Practice Address - Street 1:210 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2847
Practice Address - Country:US
Practice Address - Phone:864-979-0219
Practice Address - Fax:864-626-0466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA1669Medicaid