MEDICARE: MRS. RYAN E TERRELL LPC

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	101YM0800X	Mental Health Counselor	4701	SC
2	101YP2500X	Professional Counselor	4701	SC

General Provider Information

NPI Number	:	1639245673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RYAN E TERRELL LPC

Provider Business Mailing Address
First Line	:	4000 FABER PLACE DR STE 110
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8585
Country	:	US
Telephone Number	:	843-501-1099
Fax Number	:	843-766-8606

Provider Business Practice Location Address
First Line	:	4000 FABER PLACE DR STE 110
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8585
Country	:	US
Telephone Number	:	843-501-1099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	05/05/2025

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