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NPI Code Detail

MEDICARE: MRS. LORA CHAVIS LPC

MEDICARE: MRS. LORA CHAVIS 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
1101YP2500XProfessional Counselor5540SC
2101YM0800XMental Health Counselor5540SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SCS392OTHERSCMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760821078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORA CHAVIS LPC
Provider Business Mailing Address
First Line : PO BOX 1090
Second Line :
City : HARTSVILLE
State : SC
Zip : 29551-1090
Country : US
Telephone Number : 843-857-0111
Fax Number : 843-857-0206
Provider Business Practice Location Address
First Line : 204 PERRY WILEY WAY
Second Line :
City : CHESTERFIELD
State : SC
Zip : 29709-5701
Country : US
Telephone Number : 843-623-5080
Fax Number : 843-623-5087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2013
Last Update Date : 02/29/2024

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Directions to “ MRS. LORA CHAVIS LPC” Practice Location

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