| NPI | 1487464095 |
|---|---|
| Doing Business As | SELF |
| Entity Type | Organization |
| Authorized Contact | LEEANNE THOMPSON-FORTE Owner 803-431-1132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |