| Thomas Ray Martin, | |
|
10 Patewood Dr Ste 130, Greenville, SC 29615-6317 | |
| (864) 522-5550 | |
| (864) 455-4540 |
| Full Name | Thomas Ray Martin |
|---|---|
| Gender | Male |
| Speciality | Counselor |
| Location | 10 Patewood Dr Ste 130, Greenville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598131187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701006249 (Virginia) | Secondary |
| 101Y00000X | Counselor | 7602 (South Carolina) | Primary |
| Entity Name | Prisma Health University Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295763217 PECOS PAC ID: 8325950983 Enrollment ID: O20031103000238 |
| Entity Name | South Carolina Dept Of Mental Health Accounting Office |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619995370 PECOS PAC ID: 9032021175 Enrollment ID: O20040624000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Ray Martin, 300 E Mcbee Ave Ste 300, Greenville, SC 29601-2899 Ph: (864) 522-8611 | Thomas Ray Martin, 10 Patewood Dr Ste 130, Greenville, SC 29615-6317 Ph: (864) 522-5550 |
Ms. Jessicka Spearman Childs, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 205 Farrs Bridge Rd, Greenville, SC 29617 Phone: 864-383-0384 | |
Andrew James Tallarico, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1400 Cleveland St, Greenville, SC 29607 Phone: 864-467-3790 | |
Alondria Goode, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1708 Augusta St Ste C226, Greenville, SC 29605 Phone: 864-206-9309 | |
Alyssa Cherise Livanos, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 Pettigru St, Greenville, SC 29601 Phone: 864-271-3549 | |
Nicole Mckinney, MS, LPC, CSOTS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2510 Wade Hampton Blvd, Greenville, SC 29615 Phone: 864-509-0774 | |
Jordan Sartain, Counselor Medicare: Not Enrolled in Medicare Practice Location: 124 Mallard St, Greenville, SC 29601 Phone: 864-241-1040 | |
Sara Mcavoy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 124 Mallard St, Greenville, SC 29601 Phone: 864-549-0222 |