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General NPI Number Information
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NPI Number | 1457206104
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Entity Type | Organization
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Legal Business Name | INTENTIONAL INTERVENTION COUNSELING LLC
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 295 SOUTH MONMOUTH AVE
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City | SWANSEA
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State | SC
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Zip | 29160-8511
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Country | US
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Telephone | 803-402-4047
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Fax |
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Provider Business Mailing Address
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Address Line | 153 CRANBROOK CT
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City | GASTON
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State | SC
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Zip | 29053-8112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUCINA SMITH-BROOKS
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Credential | PH.D., LPC
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Telephone | 803-402-4047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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