Organization
TRAILSIDE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY EIDSON (CLINICAL SOCIAL WORKER)
(864) 216-7010
Entity
Organization
Contact information
Practice address
6715 STATE PARK RD, TRAVELERS REST, SC 29690-1831
(864) 216-7010
Mailing address
164 MIDWOOD RD, TRAVELERS REST, SC 29690-1864
(864) 216-7010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467052530
—
SC
Enumeration date
10/17/2022
Last updated
10/17/2022
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