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Organization

PLAY THERAPY OF SUMTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CATHERINE L GIBSON LPC (OWNER)
(803) 983-6735
Entity
Organization

Contact information

Practice address
213 N MAIN ST, SUMTER, SC 29150-4958
(803) 983-6735
Mailing address
121 N PURDY ST, SUMTER, SC 29150-4524
(803) 968-5999

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235578675
SC
Enumeration date
09/03/2019
Last updated
09/03/2019
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