| TL Johnson Counseling Services, LLC | |
|
Tracey Johnson 150 Oakland Ave. Suite 200 Rock Hill SC 29730-4068 | |
| (803) 334-4056 | |
| Not Available |
| Full Name | TL Johnson Counseling Services, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | Tracey Johnson, Rock Hill, South Carolina |
| Authorized Official Name and Position | Tracey L Johnson (OWNER) |
| Authorized Official Contact | 8033344056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| TL Johnson Counseling Services, LLC Po Box 36144 Rock Hill SC 29732-0502 Ph: (803) 334-4056 | TL Johnson Counseling Services, LLC Tracey Johnson 150 Oakland Ave. Suite 200 Rock Hill SC 29730-4068 Ph: (803) 334-4056 |
| NPI Number | 1467235143 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 08/16/2023 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 8022462613 |
|---|---|
| Medicare Enrollment ID | O20231002000213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467235143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Tracey L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396816385 PECOS PAC ID: 2062607518 Enrollment ID: I20101112000963 |
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