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Individual

SAMUEL MITCHELL ELDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LISW-CP

Contact information

Practice address
301 HALTON RD STE J, GREENVILLE, SC 29607-3498
(864) 664-2710
Mailing address
117 COMMONS WAY, GREENVILLE, SC 29611-3850
(219) 921-6988

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
Primary
13054
SC

Other

Enumeration date
06/26/2019
Last updated
03/24/2022
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