=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598669962
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE BEACON COUNSELING CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2026
-----------------------------------------------------
Last Update Date | 10/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 N MATSON ST
-----------------------------------------------------
City | KERSHAW
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29067-1218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-577-7631
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 56
-----------------------------------------------------
City | KERSHAW
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29067-0056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-577-7631
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICER
-----------------------------------------------------
Name | SCOTT THOMAS WHALEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 803-577-7628
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------