MEDICARE: LOOKING GLASS COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1649112277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOOKING GLASS COUNSELING

Provider Business Mailing Address
First Line	:	2615 CORN PILE RD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-8466
Country	:	US
Telephone Number	:	843-655-0379
Fax Number	:

Provider Business Practice Location Address
First Line	:	289 HIGHWAY 90 E UNIT H
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-9298
Country	:	US
Telephone Number	:	843-274-5010
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	JOANN RISTAU
Credential	:	MS, LPC, NCC
Telephone Number	:	843-274-5010

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “LOOKING GLASS COUNSELING ” Practice Location

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