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Organization
YOUTH FULL INNOVATIONS OF THE CAROLINA'S, LLC
Active
Organization
YOUTH FULL INNOVATIONS OF THE CAROLINA'S, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA DENHAM (OWNER)
(864) 326-5113
Entity
Organization
Contact information
Practice address
151 COMMONS WAY STE C1, GREENVILLE, SC 29611-3850
(864) 326-5113
(864) 397-4090
Mailing address
120 WILLOW WINDS DR, COLUMBIA, SC 29210-4454
(864) 326-5113
(864) 397-4090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
291U00000X
Clinical Medical Laboratory
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42D2212370
CLIA
SC
05
—
GP9178
—
SC
Enumeration date
04/29/2019
Last updated
08/25/2023
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