Provider Demographics
NPI:1194392837
Name:ISLAND COUNSELING AND BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:ISLAND COUNSELING AND BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:MCGAHEY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC
Authorized Official - Phone:843-314-1379
Mailing Address - Street 1:297 LUMBEE CIR
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-4386
Mailing Address - Country:US
Mailing Address - Phone:843-314-1379
Mailing Address - Fax:854-600-1194
Practice Address - Street 1:640 MORSE AVE BLDG B
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5115
Practice Address - Country:US
Practice Address - Phone:843-314-1379
Practice Address - Fax:854-600-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty