Provider Demographics
NPI:1043790108
Name:MAYS, ALICE DEE (MA, LPC, BC-TMH, NCC)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:DEE
Last Name:MAYS
Suffix:
Gender:F
Credentials:MA, LPC, BC-TMH, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MOLINIA DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-8692
Mailing Address - Country:US
Mailing Address - Phone:843-622-6262
Mailing Address - Fax:843-242-0329
Practice Address - Street 1:6514 DICK POND RD UNIT 102
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-9277
Practice Address - Country:US
Practice Address - Phone:843-868-5565
Practice Address - Fax:843-242-0329
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7557101YP2500X
101YP1600X, 101YP2500X
SC6622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC2288Medicaid