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General NPI Number Information
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NPI Number | 1780279562
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Entity Type | Organization
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Legal Business Name | INNER PEACE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 61 HICKORY HILL RD STE B
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City | VARNVILLE
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State | SC
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Zip | 29944-5200
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Country | US
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Telephone | 803-730-2783
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Fax | 803-914-0296
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Provider Business Mailing Address
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Address Line | 165 JEWELL AVE
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City | VARNVILLE
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State | SC
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Zip | 29944-5770
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Country | US
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Telephone | 803-730-2783
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Fax | 803-914-0296
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Authorized Official
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Title or Position | OWNER
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Name | AMBER RANEICE ALLEN
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Credential | LPC
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Telephone | 803-730-2783
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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 |
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License Number State |
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