Provider Demographics
NPI:1407634934
Name:EGAN, KIERA L (LPCA)
Entity Type:Individual
Prefix:
First Name:KIERA
Middle Name:L
Last Name:EGAN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 ALESTER SQ
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5959
Mailing Address - Country:US
Mailing Address - Phone:864-420-9083
Mailing Address - Fax:
Practice Address - Street 1:2700 E PHILLIPS RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-4815
Practice Address - Country:US
Practice Address - Phone:864-235-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8385101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor