MEDICARE: MT. HEBRON COUNSELING SERVICES

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	2754	SC
2	101YP2500X	Professional Counselor	4752	SC
3	1041C0700X	Clinical Social Worker	6694	SC
4	106H00000X	Marriage & Family Therapist	217	SC

General Provider Information

NPI Number	:	1952438376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MT. HEBRON COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	3156 LEAPHART RD
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-3024
Country	:	US
Telephone Number	:	803-791-0495
Fax Number	:	803-791-1958

Provider Business Practice Location Address
First Line	:	3156 LEAPHART RD
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-3024
Country	:	US
Telephone Number	:	803-791-0495
Fax Number	:	803-791-1958

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	EMILY JO SCOTT
Credential	:
Telephone Number	:	803-269-2916

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	12/15/2025

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