Provider Demographics
NPI:1235786963
Name:SPENRATH COUNSELING LLC
Entity Type:Organization
Organization Name:SPENRATH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-879-8515
Mailing Address - Street 1:260 SEVEN FARMS DR STE C
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8207
Mailing Address - Country:US
Mailing Address - Phone:843-879-8515
Mailing Address - Fax:
Practice Address - Street 1:89 OLD TROLLEY RD STE 210
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-4951
Practice Address - Country:US
Practice Address - Phone:843-879-8515
Practice Address - Fax:877-325-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1760878698Medicaid