Provider Demographics
NPI:1184860736
Name:WHARTON-JAMES, PHYLLIS (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:
Last Name:WHARTON-JAMES
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 OLEANDER DR
Mailing Address - Street 2:SUITES 1 & 2
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5738
Mailing Address - Country:US
Mailing Address - Phone:843-497-5240
Mailing Address - Fax:843-497-1129
Practice Address - Street 1:4603 OLEANDER DR
Practice Address - Street 2:SUITES 1 & 2
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5738
Practice Address - Country:US
Practice Address - Phone:843-497-5240
Practice Address - Fax:843-497-1129
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4732101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional