Provider Demographics
NPI:1134982200
Name:KAMP THERAPY, LLC
Entity type:Organization
Organization Name:KAMP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKAY-PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:843-415-2887
Mailing Address - Street 1:48 ROYAL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1166
Mailing Address - Country:US
Mailing Address - Phone:843-415-2887
Mailing Address - Fax:
Practice Address - Street 1:1536 FORDING ISLAND RD STE 108
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-1144
Practice Address - Country:US
Practice Address - Phone:940-594-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)