Gale Clara Dicostanzo
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Spartenburg, SC
NPI 1851001440 · NPPES record last updated Dec 5, 2022
Key facts
- NPI
- 1851001440
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 129 Dillon Drive
Spartenburg, SC 29304 - Phone
- (864) 582-7588
- Fax
- (864) 562-4117
- NPI assigned
- Dec 5, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Forrester Center for Behavioral Health, Inc. | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
Locations
129 Dillon Dr
Spartanburg, SC 29307
Phone (864) 582-7588
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
129 Dillon Drive
Spartenburg, SC 29304
Mailing address
129 Dillon Drive
Spartenburg, SC 29304
Phone (864) 582-7588
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AD10SP | Medicaid | SC |
Other providers in Spartenburg, SC
All providers in Spartenburg, SC · Addiction (Substance Use Disorder) Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.