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General NPI Number Information
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NPI Number | 1992251581
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Entity Type | Organization
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Legal Business Name | HIGHER GROUND CHRISTIAN COUNSELING SERVICE, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1801 D WEST EVANS STREET
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City | FLORENCE
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State | SC
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Zip | 29501
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Country | US
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Telephone | 843-687-8754
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Fax |
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Provider Business Mailing Address
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Address Line | 221 BIG SWAMP RD
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City | PAMPLICO
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State | SC
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Zip | 29583
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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
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Name | ANDREA MCCLAM
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Credential |
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Telephone | 843-687-8754
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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 | 6142
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License Number State | SC
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