Healthcare Provider Details

I. General information

NPI: 1184996787
Provider Name (Legal Business Name): SUMMER LYNN ZELL BCBA, LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 TALLWOOD RD
CHARLESTON SC
29412-9025
US

IV. Provider business mailing address

1529 SAM RITTENBERG BLVD STE 1B
CHARLESTON SC
29407-4125
US

V. Phone/Fax

Practice location:
  • Phone: 704-277-3635
  • Fax:
Mailing address:
  • Phone: 704-277-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10294
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: