Healthcare Provider Details

I. General information

NPI: 1295277986
Provider Name (Legal Business Name): POSITIVE SOLUTIONS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E EVANS ST SUITE 300
FLORENCE SC
29506-2511
US

IV. Provider business mailing address

181 E EVANS ST SUITE 300
FLORENCE SC
29506-2511
US

V. Phone/Fax

Practice location:
  • Phone: 843-676-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2185
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6614
License Number StateSC

VIII. Authorized Official

Name: DELORIS ANN MCKNIGHT
Title or Position: LICENSE PROFESSIONAL COUNSELOR
Credential: ED. D
Phone: 843-676-9400