MEDICARE: ENHANCEMENT COUNSELING SERVICES 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	251S00000X	Community/Behavioral Health Agency	195	SC

General Provider Information

NPI Number	:	1700368677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENHANCEMENT COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	1473 BRENWOOD RD
Second Line	:
City	:	LAKE VIEW
State	:	SC
Zip	:	29563-5724
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1473 BRENWOOD RD
Second Line	:
City	:	LAKE VIEW
State	:	SC
Zip	:	29563-5724
Country	:	US
Telephone Number	:	843-758-5235
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRIYANA MCNEIL
Credential	:	LAC
Telephone Number	:	843-758-5235

Provider Enumeration Date	:	09/06/2018
Last Update Date	:	09/06/2018

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