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General NPI Number Information
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NPI Number | 1972034619
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Entity Type | Organization
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Legal Business Name | CHOICES FOR CHANGE COUNSELING, PC
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 25 WOODS LAKE RD SUITE 412
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City | GREENVILLE
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State | SC
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Zip | 29607-6125
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Country | US
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Telephone | 864-214-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 507 CLIMBING ROSE CT
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City | FOUNTAIN INN
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State | SC
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Zip | 29644-3514
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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/THERAPIST
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Name | RONNIE MCCARRELL
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Credential | LPC
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Telephone | 864-214-4887
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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 | 5217
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License Number State | SC
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