Healthcare Provider Details

I. General information

NPI: 1639245673
Provider Name (Legal Business Name): RYAN E TERRELL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RYAN E MCDANIEL M.A.

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 FABER PLACE DR STE 110
NORTH CHARLESTON SC
29405-8585
US

IV. Provider business mailing address

4000 FABER PLACE DR STE 110
NORTH CHARLESTON SC
29405-8585
US

V. Phone/Fax

Practice location:
  • Phone: 843-501-1099
  • Fax:
Mailing address:
  • Phone: 843-501-1099
  • Fax: 843-766-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4701
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4701
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: