Organization
STEPHEN J ENNS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTI HERNDON (OFFICE MANAGER)
(803) 649-0808
Entity
Organization
Contact information
Practice address
224 GREENVILLE ST NW, AIKEN, SC 29801-3946
(803) 649-0808
(803) 649-5900
Mailing address
224 GREENVILLE ST NW, AIKEN, SC 29801-3946
(803) 649-0808
(803) 649-5900
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
14838
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00609122A
—
GA
05
—
G38477
—
SC
Enumeration date
01/07/2016
Last updated
01/07/2016
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