Provider Demographics
NPI:1215304639
Name:COUNSELING SERVICES OF ANDERSON
Entity type:Organization
Organization Name:COUNSELING SERVICES OF ANDERSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-402-9991
Mailing Address - Street 1:1944 PEARMAN DAIRY RD STE E
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-1315
Mailing Address - Country:US
Mailing Address - Phone:864-402-9991
Mailing Address - Fax:
Practice Address - Street 1:1944 PEARMAN DAIRY RD STE E
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-1315
Practice Address - Country:US
Practice Address - Phone:864-402-9991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNSELING SERVICES OF GREENVILLE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4606106H00000X
SC5318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty