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Organization
MENDED THERAPY GROUP
Active
Organization
MENDED THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MCCRAE CARROLL LPCA (THERAPIST)
(803) 450-6479
Entity
Organization
Contact information
Practice address
108 CENTRAL AVE STE 5, GOOSE CREEK, SC 29445-3079
(803) 450-6479
Mailing address
108 CENTRAL AVE STE 5, GOOSE CREEK, SC 29445-3079
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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