Healthcare Provider Details

I. General information

NPI: 1245637727
Provider Name (Legal Business Name): LEXINGTON CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E MAIN ST
LEXINGTON SC
29072-3546
US

IV. Provider business mailing address

224 E MAIN ST
LEXINGTON SC
29072-3546
US

V. Phone/Fax

Practice location:
  • Phone: 803-808-5222
  • Fax: 803-957-2062
Mailing address:
  • Phone: 803-808-5222
  • Fax: 803-957-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROBIN TEMPLES
Title or Position: DIRECTOR
Credential: LMFT/S
Phone: 803-808-5222