Healthcare Provider Details

I. General information

NPI: 1356564397
Provider Name (Legal Business Name): KATRINA KELLY PRESSLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 WACCAMAW MEDICAL PARK DR
CONWAY SC
29526-8903
US

IV. Provider business mailing address

164 WACCAMAW MEDICAL PARK DR
CONWAY SC
29526-8903
US

V. Phone/Fax

Practice location:
  • Phone: 843-492-2795
  • Fax: 843-215-0118
Mailing address:
  • Phone: 843-492-2795
  • Fax: 843-215-0118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6834
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number484
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: