Provider Demographics
NPI:1548376155
Name:THREADGILL, A HOPE (PSYD)
Entity type:Individual
Prefix:DR
First Name:A
Middle Name:HOPE
Last Name:THREADGILL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:HOPE
Other - Middle Name:
Other - Last Name:THREADGILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:214 KEOWEE TRAIL
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29633-0187
Mailing Address - Country:US
Mailing Address - Phone:864-654-7858
Mailing Address - Fax:864-654-7972
Practice Address - Street 1:214 KEOWEE TRL
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1448
Practice Address - Country:US
Practice Address - Phone:864-654-7858
Practice Address - Fax:864-654-7972
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC 1728101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional