Provider Demographics
NPI:1770063315
Name:SPRINGS OF LIFE COUNSELING LLC
Entity type:Organization
Organization Name:SPRINGS OF LIFE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:803-626-6200
Mailing Address - Street 1:123 HAWKS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0026
Mailing Address - Country:US
Mailing Address - Phone:803-626-6200
Mailing Address - Fax:
Practice Address - Street 1:1808 SECOND BAXTER XING STE 208
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6492
Practice Address - Country:US
Practice Address - Phone:803-626-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC127511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty