Organization
180 THERAPY LIFE COACHING & CONSULTING, LLC
Active
Other names
180 TLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHUKAIRO MACK BAKER LCSW, LCAS, RN (CLINICAL DIRECTOR)
(980) 309-8508
Entity
Organization
Contact information
Practice address
331 E MAIN ST, ROCK HILL, SC 29730-5383
(803) 708-7556
Mailing address
2431 ENCHANTO RD, YORK, SC 29745-9795
(980) 309-8508
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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