Upstate Restorative Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

UPSTATE RESTORATIVE COUNSELING, LLC

Practice address

301 Halton Rd Ste J
Greenville, SC 29607-3498

Phone

(864) 664-2710

NPI assigned

Jan 29, 2021

Last updated

Mar 2, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ann Marie Simmons, LISW-CPNPI 1710495056

Title

Owner/Therapist

Phone

(864) 567-3102

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ann Marie Simmons, LISW-CP

  • Clinical Social Worker
  • Greenville, SC
  • NPI 1710495056
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1003407354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HALTON RD STE J",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073498",
            "telephone_number": "886-664-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HALTON RD STE J",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073498",
            "telephone_number": "864-664-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE RESTORATIVE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "864-567-3102",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Greenville, SC
• Providers in Greenville, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.