Healthcare Provider Details

I. General information

NPI: 1134960602
Provider Name (Legal Business Name): ONE STEP FORWARD COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E EVANS ST STE 314
FLORENCE SC
29506-2511
US

IV. Provider business mailing address

181 E EVANS ST STE 314
FLORENCE SC
29506-2511
US

V. Phone/Fax

Practice location:
  • Phone: 843-942-9434
  • Fax: 843-790-1227
Mailing address:
  • Phone: 843-260-9067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY BOATWRIGHT
Title or Position: LPC
Credential: MA
Phone: 843-942-9434