Healthcare Provider Details

I. General information

NPI: 1689593493
Provider Name (Legal Business Name): CALLISON COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAKEVIEW DR
SUMMERVILLE SC
29485-8311
US

IV. Provider business mailing address

411 LAKEVIEW DR
SUMMERVILLE SC
29485-8311
US

V. Phone/Fax

Practice location:
  • Phone: 843-345-3476
  • Fax:
Mailing address:
  • Phone: 843-345-3476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. AMANDA CALLISON NEIKIRK
Title or Position: COUNSELOR
Credential: LPC, ME.D
Phone: 843-345-3476