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General NPI Number Information
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NPI Number | 1306203310
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Entity Type | Organization
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Legal Business Name | HIGHLY FAVORED LLC
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 65 SANDERS LN
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City | CHERAW
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State | SC
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Zip | 29520
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Country | US
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Telephone | 910-995-7918
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 882
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City | CHERAW
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State | SC
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Zip | 29520-0882
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Country | US
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Telephone | 843-865-7005
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. PATRICIA MCCORMICK EVANS
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Credential | MA, LPC, LCASA
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Telephone | 910-995-7918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2865A
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9734
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | SC
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