Organization
MIND RENEWAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRANDY THOMPSON-FISHER LISW-CP (CLINICAL SOCIAL WORKER)
(443) 867-6663
Entity
Organization
Contact information
Practice address
439 CONGAREE RD, GREENVILLE, SC 29607-2867
(864) 509-9087
(864) 509-9072
Mailing address
439 CONGAREE RD, GREENVILLE, SC 29607-2867
(864) 509-9087
(864) 509-9072
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10538
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1164
—
SC
Enumeration date
04/15/2014
Last updated
04/15/2014
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