Individual
MR. TAVIS CONNOR ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3211 REIDVILLE RD STE C, SPARTANBURG, SC 29301-6120
(864) 278-0593
(864) 586-2300
Mailing address
200 HEYWOOD AVE, SPARTANBURG, SC 29307-1706
(606) 793-1398
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10170
SC
Other
Enumeration date
09/10/2024
Last updated
06/16/2025
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