MEDICARE: TRI-COUNTY EARLY INTERVENTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1396696811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-COUNTY EARLY INTERVENTION LLC

Provider Business Mailing Address
First Line	:	759 MUIRHEAD RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-2712
Country	:	US
Telephone Number	:	843-860-9828
Fax Number	:

Provider Business Practice Location Address
First Line	:	759 MUIRHEAD RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-2712
Country	:	US
Telephone Number	:	843-860-9828
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALLISON LYNNE SELK
Credential	:
Telephone Number	:	843-860-9828

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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