Trailside Counseling

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

TRAILSIDE COUNSELING

Practice address

6715 State Park Rd
Travelers Rest, SC 29690-1831

Phone

(864) 216-7010

NPI assigned

Oct 17, 2022

Organization subpart

No

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

Authorized official

Name

Courtney EidsonNPI 1871043992

Title

Clinical Social Worker

Phone

(864) 216-7010

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Courtney Eidson

  • Social Worker
  • Travelers Rest, SC
  • NPI 1871043992
  NPD Authorized official

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1154047702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 MIDWOOD RD",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901864",
            "telephone_number": "864-216-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 STATE PARK RD",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901831",
            "telephone_number": "864-216-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAILSIDE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A",
        "authorized_official_last_name": "EIDSON",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "864-216-7010"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467052530",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony B Tomkins, MSPT
• Gerald Drew Toney
• TR Talkers, LLC
• Trailhead Chiropractic
• Trailhead Family Dentistry LLC
• Travelers Rest Internal Medicine, LLC
• Tristate Medical Services
• Laura H. Turman, RPH.
• Upcountry Counseling and Mental Health Services, LLC
• Nathanial Lawrence Vandyke, PT

• Mental Health Counselor in Travelers Rest, SC
• Providers in Travelers Rest, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.