Provider Demographics
NPI:1174033617
Name:COUNSELING ASSOCIATES OF AIKEN, LLC
Entity Type:Organization
Organization Name:COUNSELING ASSOCIATES OF AIKEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:ELWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:803-439-7013
Mailing Address - Street 1:6130 WOODSIDE EXECUTIVE CT
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-3820
Mailing Address - Country:US
Mailing Address - Phone:803-226-0190
Mailing Address - Fax:
Practice Address - Street 1:6130 WOODSIDE EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-3820
Practice Address - Country:US
Practice Address - Phone:803-226-0190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC103491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1335Medicaid