Provider Demographics
NPI:1124569595
Name:BUILDING THE WAY COUNSELING AND CONSULTING LLC
Entity Type:Organization
Organization Name:BUILDING THE WAY COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,LMHC
Authorized Official - Phone:518-578-1014
Mailing Address - Street 1:1430 COTTAGE COVE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-5965
Mailing Address - Country:US
Mailing Address - Phone:518-578-1014
Mailing Address - Fax:843-390-2379
Practice Address - Street 1:2200 PREMIER RESORT BLVD
Practice Address - Street 2:UNIT C
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-9203
Practice Address - Country:US
Practice Address - Phone:843-907-3594
Practice Address - Fax:843-390-2379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6095101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty