| Revive Counseling Professionals Llc | |
|
202 Sandy Shores Dr Townville SC 29689-4247 | |
| (864) 832-2296 | |
| Not Available |
| Full Name | Revive Counseling Professionals Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 202 Sandy Shores Dr, Townville, South Carolina |
| Authorized Official Name and Position | Jeremy Jason Ray (MENTAL HEALTH PRACTITIONER) |
| Authorized Official Contact | 8648322296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Counseling Professionals Llc 202 Sandy Shores Dr Townville SC 29689-4247 Ph: (864) 832-2296 | Revive Counseling Professionals Llc 202 Sandy Shores Dr Townville SC 29689-4247 Ph: (864) 832-2296 |
| NPI Number | 1164279055 |
|---|---|
| Provider Enumeration Date | 04/30/2024 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164279055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |