Provider Demographics
NPI:1922037803
Name:WESTGATE TRAINING AND CONSULTATION NETWORK
Entity Type:Organization
Organization Name:WESTGATE TRAINING AND CONSULTATION NETWORK
Other - Org Name:WESTGATE FAMILY THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:BLAIR
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-583-1010
Mailing Address - Street 1:167 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-1501
Mailing Address - Country:US
Mailing Address - Phone:864-583-1010
Mailing Address - Fax:864-582-6361
Practice Address - Street 1:167 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1501
Practice Address - Country:US
Practice Address - Phone:864-583-1010
Practice Address - Fax:864-582-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========Medicare UPIN