MEDICARE: CAREY COUNSELING, LLC

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	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689277923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREY COUNSELING, LLC

Provider Business Mailing Address
First Line	:	727 PEPPERBUSH DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4163
Country	:	US
Telephone Number	:	843-333-1363
Fax Number	:

Provider Business Practice Location Address
First Line	:	727 PEPPERBUSH DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4163
Country	:	US
Telephone Number	:	843-564-2063
Fax Number	:	864-448-1448

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	MS. VICTORIA CAREY
Credential	:	LISW-CP
Telephone Number	:	843-333-1363

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	11/20/2020

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