Healthcare Provider Details

I. General information

NPI: 1841101987
Provider Name (Legal Business Name): DEANE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2462 WINDMILL WAY
MYRTLE BEACH SC
29579-3534
US

IV. Provider business mailing address

505 AZOLLA WAY
STAFFORD VA
22554-6883
US

V. Phone/Fax

Practice location:
  • Phone: 908-370-4650
  • Fax:
Mailing address:
  • Phone: 908-370-4650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: THAIS DEANE
Title or Position: LISW-CP, LCSW, OWNER
Credential: LISW-CP, LCSW
Phone: 908-370-4650