Healthcare Provider Details

I. General information

NPI: 1013132752
Provider Name (Legal Business Name): RUWACH COUNSELING & CONSULTING SERVICES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 CENTERMARSH LN
PAWLEYS ISLAND SC
29585-6104
US

IV. Provider business mailing address

PO BOX 4027
PAWLEYS ISLAND SC
29585-4027
US

V. Phone/Fax

Practice location:
  • Phone: 843-344-0172
  • Fax:
Mailing address:
  • Phone: 843-344-0172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1764
License Number StateSC

VIII. Authorized Official

Name: MRS. ACTON B BEARD
Title or Position: PARTNER
Credential: LPC, LPCS, EDS.
Phone: 843-340-3219