=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740120427
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOOTHILLS FAMILY COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2026
-----------------------------------------------------
Last Update Date | 03/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150A SCHOOL HOUSE RD
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29693-5945
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-280-9317
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 158 GRANT RD
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29693-5909
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-737-4075
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC DIRECTOR
-----------------------------------------------------
Name | BENTLEY HIVELY GAMBRELL
-----------------------------------------------------
Credential | LPC, M. ED.
-----------------------------------------------------
Telephone | 423-737-4075
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------