Provider Demographics
NPI:1962839712
Name:SYNERGY COUNSELING OF GREENWOOD
Entity Type:Organization
Organization Name:SYNERGY COUNSELING OF GREENWOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EARCELIA
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-223-2243
Mailing Address - Street 1:128 MAXWELL AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2641
Mailing Address - Country:US
Mailing Address - Phone:864-223-2243
Mailing Address - Fax:
Practice Address - Street 1:128 MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2641
Practice Address - Country:US
Practice Address - Phone:864-223-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4252101YP2500X
SC85511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1639423767OtherINDIVIDUAL NPI NUMBER
SC1952593923OtherINDIVIDUAL NPI NUMBER