Healthcare Provider Details

I. General information

NPI: 1013830553
Provider Name (Legal Business Name): ANCHOR THERAPY AND EMOTIONAL WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 KENNEBEL PL
FORT MILL SC
29715-4101
US

IV. Provider business mailing address

335 KENNEBEL PL
FORT MILL SC
29715-4101
US

V. Phone/Fax

Practice location:
  • Phone: 803-402-3585
  • Fax:
Mailing address:
  • Phone: 803-402-3585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN WALLACE
Title or Position: LPC-A/OWNER
Credential: LPC-A
Phone: 980-613-1443