Provider Demographics
NPI:1225083686
Name:FAHY-RAWLINSON, MARGARET ANGELIQUE (LPC, LPC/S, LMT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANGELIQUE
Last Name:FAHY-RAWLINSON
Suffix:
Gender:F
Credentials:LPC, LPC/S, LMT
Other - Prefix:
Other - First Name:M.
Other - Middle Name:ANGELIQUE
Other - Last Name:FAHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LMT
Mailing Address - Street 1:800 15TH AVENUE SOUTH
Mailing Address - Street 2:PO BOX 5381
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29597
Mailing Address - Country:US
Mailing Address - Phone:843-446-6222
Mailing Address - Fax:843-734-0638
Practice Address - Street 1:34 HIGHWAY 90 E
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-9279
Practice Address - Country:US
Practice Address - Phone:843-446-6222
Practice Address - Fax:843-734-0638
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4582101YP2500X
SC1530174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC9348Medicare PIN