Healthcare Provider Details

I. General information

NPI: 1942134911
Provider Name (Legal Business Name): RAW COUNSELING & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8441 OLD STATE ROAD
HOLLY HILL SC
29059
US

IV. Provider business mailing address

8441 OLD STATE ROAD
HOLLY HILL SC
29059
US

V. Phone/Fax

Practice location:
  • Phone: 803-997-0840
  • Fax: 803-265-3365
Mailing address:
  • Phone: 803-997-0840
  • Fax: 803-265-3365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEVONTA R CHILDS
Title or Position: THERAPSIT
Credential: LPC
Phone: 803-347-6147