MEDICARE: YOUR COUNSELING SERVICES INC

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	171W00000X	Contractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11850682	OTHER		CAQH PROVIDER ID

General Provider Information

NPI Number	:	1730212028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR COUNSELING SERVICES INC

Provider Business Mailing Address
First Line	:	6650 RIVERS AVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	843-260-5361
Fax Number	:

Provider Business Practice Location Address
First Line	:	6650 RIVERS AVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	843-576-5400
Fax Number	:

Authorized Official
Title or Position	:	INTERNATIONAL ASSOCIATION OF CLINIC
Name	:	MS. KEM DENICE FRASIER
Credential	:	IACTP
Telephone Number	:	843-260-5361

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	06/20/2018

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Directions to “YOUR COUNSELING SERVICES INC ” Practice Location

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