Bridges Clubhouse Mental Health of America South Carolina

Organization Active NPI Mental Health Counselor · Cayce, SC

NPI 1083815674 · NPPES record last updated Aug 7, 2007

Key facts

NPI
1083815674
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
License
01858 600 (SC)
Legal business name
BRIDGES CLUBHOUSE MENTAL HEALTH OF AMERICA SOUTH CAROLINA
Practice address
2105 Commerce Dr
Cayce, SC 29033-1524
Phone
(803) 796-6179
NPI assigned
May 30, 2007
Organization subpart
No

Authorized official

Name
Miss Kelly Ann Tucker, M.R.C.
Title
Clinical Counselor
Phone
(803) 796-0353

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Bridges Clubhouse (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YM0800X 01858 600 SC Yes

Addresses

Primary practice location

2105 Commerce Dr
Cayce, SC 29033-1524

Mailing address

2021 Elm Abode Ter
Columbia, SC 29210-7724
Phone (803) 446-4246

Other providers in Cayce, SC

All providers in Cayce, SC · Mental Health Counselor in South Carolina

Sources for this page

Verify at the official NPI Registry.