Healthcare Provider Details

I. General information

NPI: 1649112277
Provider Name (Legal Business Name): LOOKING GLASS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 HIGHWAY 90 E UNIT H
LITTLE RIVER SC
29566-9298
US

IV. Provider business mailing address

2615 CORN PILE RD
MYRTLE BEACH SC
29588-8466
US

V. Phone/Fax

Practice location:
  • Phone: 843-274-5010
  • Fax:
Mailing address:
  • Phone: 843-655-0379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOANN RISTAU
Title or Position: OWNER/THERAPIST
Credential: MS, LPC, NCC
Phone: 843-274-5010