Provider Demographics
NPI:1407133770
Name:MT. HEBRON COUNSELING SERVICES
Entity Type:Organization
Organization Name:MT. HEBRON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARWICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:803-791-0495
Mailing Address - Street 1:3050 LEAPHART RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3000
Mailing Address - Country:US
Mailing Address - Phone:803-791-0495
Mailing Address - Fax:803-791-1958
Practice Address - Street 1:3050 LEAPHART RD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3000
Practice Address - Country:US
Practice Address - Phone:803-791-0495
Practice Address - Fax:803-791-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2970103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty