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General NPI Number Information
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NPI Number | 1376890616
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Entity Type | Organization
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Legal Business Name | ARCHWOOD COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 203 W MAIN ST SUITE E-1
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City | LEXINGTON
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State | SC
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Zip | 29072-2633
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Country | US
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Telephone | 803-873-8332
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Fax |
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Provider Business Mailing Address
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Address Line | 222 ROSE LAKE RD
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City | LEXINGTON
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State | SC
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Zip | 29072-9494
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Country | US
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Telephone | 803-873-8332
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN CONWAY
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Credential | LCPC, LPC
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Telephone | 803-873-8332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5224
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License Number State | SC
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