1457782914 NPI number — POSITIVE SOLUTIONS COUNSELING SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457782914 NPI number — POSITIVE SOLUTIONS COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POSITIVE SOLUTIONS COUNSELING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457782914
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3255 LANDMARK DR
Provider Second Line Business Mailing Address:
BUILDING 200, SUITE 203
Provider Business Mailing Address City Name:
NORTH CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29418-8461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3255 LANDMARK DR
Provider Second Line Business Practice Location Address:
BUILDING 200, SUITE 203
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29418-8461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-259-1995
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BUTTS
Authorized Official First Name:
ELSA
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNSELOR
Authorized Official Telephone Number:
843-259-1995

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  5412 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X , with the licence number: 5452 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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