Provider Demographics
NPI:1679049712
Name:GREENVILLE THERAPY AND COUNSELING CENTER PLLC
Entity Type:Organization
Organization Name:GREENVILLE THERAPY AND COUNSELING CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNEDY
Authorized Official - Middle Name:KIMBERLY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:508-326-9929
Mailing Address - Street 1:1206 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4102
Mailing Address - Country:US
Mailing Address - Phone:252-777-3137
Mailing Address - Fax:252-777-3137
Practice Address - Street 1:1206 EVANS ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4102
Practice Address - Country:US
Practice Address - Phone:252-777-3137
Practice Address - Fax:252-777-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty