Provider Demographics
NPI:1043432180
Name:PALMETTO FAMILY WORKS LLC
Entity type:Organization
Organization Name:PALMETTO FAMILY WORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:F
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-615-2770
Mailing Address - Street 1:887 NE MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2041
Mailing Address - Country:US
Mailing Address - Phone:843-615-2770
Mailing Address - Fax:864-228-7247
Practice Address - Street 1:2135 HOFFMEYER RD STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4087
Practice Address - Country:US
Practice Address - Phone:843-615-2770
Practice Address - Fax:864-228-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4156101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP547Medicaid
SCGP5471Medicaid