| MR Therapy | |
|
3800 Forest Dr Ste A205 Columbia SC 29204-4146 | |
| (803) 542-9603 | |
| Not Available |
| Full Name | MR Therapy |
|---|---|
| Speciality | Counselor |
| Location | 3800 Forest Dr Ste A205, Columbia, South Carolina |
| Authorized Official Name and Position | Michael Joseph Ruguleiski (OWNER) |
| Authorized Official Contact | 8032401967 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| MR Therapy 246 Columbia Club Dr E Blythewood SC 29016-9479 Ph: (803) 240-1967 | MR Therapy 3800 Forest Dr Ste A205 Columbia SC 29204-4146 Ph: (803) 542-9603 |
| NPI Number | 1013719327 |
|---|---|
| Provider Enumeration Date | 03/26/2025 |
| Last Update Date | 03/26/2025 |
| Certification Date | 03/26/2025 |
| Medicare PECOS PAC ID | 9638693179 |
|---|---|
| Medicare Enrollment ID | O20250407001861 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013719327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Michael Joseph Ruguleiski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730888678 PECOS PAC ID: 1456875996 Enrollment ID: I20250407002205 |
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