Provider Demographics
NPI:1679274815
Name:PALMETTO COUNSELING CENTER
Entity Type:Organization
Organization Name:PALMETTO COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:MS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:843-536-4749
Mailing Address - Street 1:811 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4350
Mailing Address - Country:US
Mailing Address - Phone:843-536-4749
Mailing Address - Fax:843-989-0205
Practice Address - Street 1:811 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4350
Practice Address - Country:US
Practice Address - Phone:843-536-4749
Practice Address - Fax:843-989-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)