=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841249877
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASHLEY COUNSELING ASSOCIATES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2006
-----------------------------------------------------
Last Update Date | 11/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 N CEDAR ST STE 100
-----------------------------------------------------
City | SUMMERVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29483-6453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-821-2480
-----------------------------------------------------
Fax | 843-875-3149
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 N CEDAR ST STE 100
-----------------------------------------------------
City | SUMMERVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29483-6453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-821-2480
-----------------------------------------------------
Fax | 843-875-3149
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER-VICE-PRESIDENT
-----------------------------------------------------
Name | MS. RHONDA WILLIAMS BURKE
-----------------------------------------------------
Credential | M.ED. LPC NCC
-----------------------------------------------------
Telephone | 843-821-2480
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | LPC 463
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------