# BEHAVIORS A GO-GO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972165041
- **Authorized official:** ELIZA KATHLEEN MCCORMICK (BILLING & CREDENTIAING MANAGER)
- **Authorized official phone:** (864) 920-2527

## Contact information

- **Practice address:** 511 W BUTLER RD, GREENVILLE, SC 29607-4890
- **Practice address phone:** (864) 757-9918
- **Practice address fax:** (864) 757-9921
- **Mailing address:** 219 GERALD DR, SIMPSONVILLE, SC 29681-4111
- **Mailing address phone:** (864) 757-9918
- **Mailing address fax:** (864) 757-9921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | — | NULL | — |
| 2251P0200X | Pediatric Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/28/2019
- **Last updated:** 06/28/2019