| Mental Health Therapy Center - Charleston, Llc | |
|
40 Calhoun St Ste 230 Charleston SC 29401-3534 | |
| (843) 797-4200 | |
| Not Available |
| Full Name | Mental Health Therapy Center - Charleston, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 40 Calhoun St Ste 230, Charleston, South Carolina |
| Authorized Official Name and Position | Joanne Trout (VICE PRESIDENT) |
| Authorized Official Contact | 9543256750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Therapy Center - Charleston, Llc 2000 Health Park Dr Brentwood TN 37027-4692 Ph: (615) 373-7406 | Mental Health Therapy Center - Charleston, Llc 40 Calhoun St Ste 230 Charleston SC 29401-3534 Ph: (843) 797-4200 |
| NPI Number | 1902647928 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 03/26/2025 |
| Certification Date | 03/26/2025 |
| Medicare PECOS PAC ID | 5193252328 |
|---|---|
| Medicare Enrollment ID | O20241230000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902647928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Patricia Spens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699479048 PECOS PAC ID: 5496288466 Enrollment ID: I20241029003423 |
| Provider Name | Michelle Allison Park |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316608300 PECOS PAC ID: 8022545268 Enrollment ID: I20241230000660 |
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University Medical Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 171 Ashley Ave, Charleston, SC 29425 Phone: 843-792-1414 | |
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