Individual
SAMANTHA NICOLE ROUSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC I
Contact information
Practice address
405 PETTIGRU ST, GREENVILLE, SC 29601-3114
(864) 271-3549
Mailing address
405 PETTIGRU ST, GREENVILLE, SC 29601-3114
(864) 271-3549
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
Enumeration date
07/03/2008
Last updated
10/10/2018
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