Provider Demographics
NPI:1225165871
Name:CW COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:CW COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:SHAVEN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP-S
Authorized Official - Phone:843-667-1905
Mailing Address - Street 1:1505 HERITAGE LN STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3141
Mailing Address - Country:US
Mailing Address - Phone:843-667-1905
Mailing Address - Fax:843-667-1723
Practice Address - Street 1:1505 HERITAGE LN STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3141
Practice Address - Country:US
Practice Address - Phone:843-667-1905
Practice Address - Fax:843-667-1723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC55321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5489Medicaid
SC376241Medicaid
SCGP5489Medicaid