Provider Demographics
NPI:1427065523
Name:THREE SPRINGS DIALECTICAL BEHAVIOR THERAPY GROUP, LLC
Entity type:Organization
Organization Name:THREE SPRINGS DIALECTICAL BEHAVIOR THERAPY GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-242-5551
Mailing Address - Street 1:100 WHITSETT ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3139
Mailing Address - Country:US
Mailing Address - Phone:864-242-5551
Mailing Address - Fax:864-242-9628
Practice Address - Street 1:100 WHITSETT ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3139
Practice Address - Country:US
Practice Address - Phone:864-242-5551
Practice Address - Fax:864-242-9628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty