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Organization

YOUTH FULL INNOVATIONS OF THE CAROLINA'S, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERICA DENHAM (OWNER)
(864) 326-5113
Entity
Organization

Contact information

Practice address
151 COMMONS WAY STE C1, GREENVILLE, SC 29611-3850
(864) 326-5113
(864) 397-4090
Mailing address
120 WILLOW WINDS DR, COLUMBIA, SC 29210-4454
(864) 326-5113
(864) 397-4090

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
101YS0200X
School Counselor
103K00000X
Behavior Analyst
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TC0700X
Clinical Psychologist
106H00000X
Marriage & Family Therapist
171M00000X
Case Manager/Care Coordinator
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
291U00000X
Clinical Medical Laboratory
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
42D2212370
CLIA
SC
05
GP9178
SC
Enumeration date
04/29/2019
Last updated
08/25/2023
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