Provider Demographics
NPI:1215342555
Name:C.H.A.T. COUNSELING
Entity type:Organization
Organization Name:C.H.A.T. COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:803-361-6307
Mailing Address - Street 1:160 LANGFORD RD
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-8746
Mailing Address - Country:US
Mailing Address - Phone:803-361-6307
Mailing Address - Fax:803-736-5310
Practice Address - Street 1:160 LANGFORD RD
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-8746
Practice Address - Country:US
Practice Address - Phone:803-361-6307
Practice Address - Fax:803-736-5310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:C.H.A.T. COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-25
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP6654Medicaid