Organization
SPEAKEASY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MARIA ROBERTSON MMFT, LMFT (OWNER)
(864) 590-1077
Entity
Organization
Contact information
Practice address
102 SHEA ST, SUMMERVILLE, SC 29485-7350
(864) 590-1077
Mailing address
102 SHEA ST, SUMMERVILLE, SC 29485-7350
(864) 590-1077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/06/2022
Last updated
07/21/2023
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