| Therapycentral Inc | |
|
5335 N Kings Hwy Ste 1205 Myrtle Beach SC 29577-2520 | |
| (732) 485-1301 | |
| (302) 469-2115 |
| Full Name | Therapycentral Inc |
|---|---|
| Speciality | Psychologist |
| Location | 5335 N Kings Hwy Ste 1205, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Yasir J. Ahmad (OWNER) |
| Authorized Official Contact | 7324851301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapycentral Inc 79 Ogle Rd Old Tappan NJ 07675-7026 Ph: (732) 485-1301 | Therapycentral Inc 5335 N Kings Hwy Ste 1205 Myrtle Beach SC 29577-2520 Ph: (732) 485-1301 |
| NPI Number | 1699429720 |
|---|---|
| Provider Enumeration Date | 02/08/2022 |
| Last Update Date | 11/03/2025 |
| Certification Date | 11/03/2025 |
| Medicare PECOS PAC ID | 8820475189 |
|---|---|
| Medicare Enrollment ID | O20220507000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699429720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (NU) | Primary |
| Provider Name | Adrian Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811495120 PECOS PAC ID: 4082011820 Enrollment ID: I20210923000794 |
| Provider Name | Casey Nobile |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023602232 PECOS PAC ID: 5890226906 Enrollment ID: I20241120002926 |
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