Provider Information for 1871767095
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
TODD STEPHEN GOMEZ LCSW,LISW
Sex: Male
NPI: 1871767095
Last Updated: 2019-12-31
Certification Date: 2019-12-31
Certification Date: 2019-12-31
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1871767095 | ||||||||||||
| Enumeration Date | 2008-04-18 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 701 W CHURCH ST SALUDA, SC 29138-7343 United States Phone: 864-263-7532 | Fax:803-324-4644 | ||||||||||||
| Primary Practice Address | 248 ADLEY WAY GREENVILLE, SC 29607-6511 United States Phone: 864-263-7532 | Fax:803-324-4644 | ||||||||||||
| Secondary Practice Address(es) | |||||||||||||
| Health Information Exchange |
| ||||||||||||
| Other Identifiers |
| ||||||||||||
| Taxonomy |
|