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Organization
THE FIFTH SEASON CENTER FOR LOSS GRIEF AND TRANSITION
Active
Organization
THE FIFTH SEASON CENTER FOR LOSS GRIEF AND TRANSITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTIE S BRODERICK LISW (EXECUTIVE DIRECTOR)
(864) 404-5070
Entity
Organization
Contact information
Practice address
111 MILLS AVE, GREENVILLE, SC 29605-4017
(864) 241-8222
(864) 241-8222
Mailing address
111 MILLS AVE, GREENVILLE, SC 29605-4017
(864) 241-8222
(864) 241-8222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
5150
SC
1041C0700X
Clinical Social Worker
Primary
1305
SC
Other
Enumeration date
06/30/2011
Last updated
09/06/2011
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