Provider Demographics
NPI:1891338794
Name:BABCOCK, JOE (EDS)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SUGARFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3353
Mailing Address - Country:US
Mailing Address - Phone:864-315-0991
Mailing Address - Fax:
Practice Address - Street 1:101 SUGARFIELD CT
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-3353
Practice Address - Country:US
Practice Address - Phone:864-315-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC503937103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool