Healthcare Provider Details

I. General information

NPI: 1891301081
Provider Name (Legal Business Name): LELLE F TOTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 CLEBOURNE ST
FORT MILL SC
29715-1753
US

IV. Provider business mailing address

122 CLEBOURNE ST
FORT MILL SC
29715-1753
US

V. Phone/Fax

Practice location:
  • Phone: 704-931-1010
  • Fax:
Mailing address:
  • Phone: 646-643-1099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10276
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: