MEDICARE: ABC WAY 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1578058566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC WAY LLC

Provider Business Mailing Address
First Line	:	1605 CENTRAL AVE STE 6
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-9386
Country	:	US
Telephone Number	:	843-793-8147
Fax Number	:	843-887-8265

Provider Business Practice Location Address
First Line	:	317 RUTHERFORD ST
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-5945
Country	:	US
Telephone Number	:	843-793-8147
Fax Number	:	843-887-8265

Authorized Official
Title or Position	:	OWNER
Name	:	ASHLEY LEITNER BELT
Credential	:	BCBA
Telephone Number	:	843-793-8147

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	03/02/2026

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