Provider Demographics
NPI:1174725527
Name:PACE CENTER OF MENTALHEALTHAMERICA&CAROLINACOUNSELING,INC.
Entity type:Organization
Organization Name:PACE CENTER OF MENTALHEALTHAMERICA&CAROLINACOUNSELING,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMER-STRAIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-583-5802
Mailing Address - Street 1:186 W MAIN ST
Mailing Address - Street 2:MASONIC TEMPLE
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-2333
Mailing Address - Country:US
Mailing Address - Phone:864-583-5802
Mailing Address - Fax:864-582-2697
Practice Address - Street 1:186 W MAIN ST
Practice Address - Street 2:MASONIC TEMPLE
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-2333
Practice Address - Country:US
Practice Address - Phone:864-583-5802
Practice Address - Fax:864-582-2697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2003104100000X
SC2244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty