Basic Information
Provider Information
NPI: 1780795252
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TEAMER
FirstName: CYNTHIA
MiddleName: PERRY
NamePrefix: MRS.
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 MCGEE RD
Address2:  
City: ANDERSON
State: SC
PostalCode: 296252104
CountryCode: US
TelephoneNumber: 8642602220
FaxNumber: 8642602225
Practice Location
Address1: 200 MCGEE RD
Address2:  
City: ANDERSON
State: SC
PostalCode: 296252104
CountryCode: US
TelephoneNumber: 8642297120
FaxNumber: 8642295526
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 05/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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