| Upstate Mental Health, Llc | |
|
104 N Daniel Morgan Ave Ste 105 Spartanburg SC 29306-2363 | |
| (864) 365-2729 | |
| (864) 383-5093 |
| Full Name | Upstate Mental Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 N Daniel Morgan Ave Ste 105, Spartanburg, South Carolina |
| Authorized Official Name and Position | Ashley Cromer (RN/PRACTICE MANAGER) |
| Authorized Official Contact | 8643652729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Mental Health, Llc 104 N Daniel Morgan Ave Ste 105 Spartanburg SC 29306-2363 Ph: (864) 365-2729 | Upstate Mental Health, Llc 104 N Daniel Morgan Ave Ste 105 Spartanburg SC 29306-2363 Ph: (864) 365-2729 |
| NPI Number | 1225787005 |
|---|---|
| Provider Enumeration Date | 03/21/2022 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Medicare PECOS PAC ID | 9739566548 |
|---|---|
| Medicare Enrollment ID | O20220517002350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225787005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kevin L Cromer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184256174 PECOS PAC ID: 3173952439 Enrollment ID: I20220517002467 |
| Provider Name | Megan Kay Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184838617 PECOS PAC ID: 9234582149 Enrollment ID: I20240126003338 |
| Provider Name | Elizabeth Danielle Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427834860 PECOS PAC ID: 7416393665 Enrollment ID: I20240309000764 |
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