Healthcare Provider Details

I. General information

NPI: 1477397289
Provider Name (Legal Business Name): LEAN ON ME CONSULTING 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2166 GOLD HILL RD STE 4
FORT MILL SC
29708-9351
US

IV. Provider business mailing address

1750 HIGHWAY 160 W STE 101-304
FORT MILL SC
29708-8009
US

V. Phone/Fax

Practice location:
  • Phone: 803-973-0221
  • Fax: 803-973-0207
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: JEWELL THOMPSON
Title or Position: CEO
Credential:
Phone: 803-973-0221