Organization
A CHILD'S BRIGHT START
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEINOSHA KEATON MSW (OWNER)
(214) 601-6208
Entity
Organization
Contact information
Practice address
22 PLEASANT RIDGE AVE, GREENVILLE, SC 29605-2112
(214) 601-6208
Mailing address
22 PLEASANT RIDGE AVE, GREENVILLE, SC 29605-2112
(214) 601-6208
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/23/2015
Last updated
01/07/2016
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