Healthcare Provider Details

I. General information

NPI: 1457758732
Provider Name (Legal Business Name): DONNA HERCHEK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S MAIN ST
LANCASTER SC
29720-2442
US

IV. Provider business mailing address

114 S MAIN ST
LANCASTER SC
29720-2442
US

V. Phone/Fax

Practice location:
  • Phone: 803-285-6911
  • Fax: 803-286-6697
Mailing address:
  • Phone: 803-285-6911
  • Fax: 803-286-6697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3434
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3434
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: