Provider Demographics
NPI:1417303967
Name:FOOTHOLD COUNSELING, LLC
Entity Type:Organization
Organization Name:FOOTHOLD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:FRYE
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:803-760-7490
Mailing Address - Street 1:163 HOLLIS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-7928
Mailing Address - Country:US
Mailing Address - Phone:803-240-4542
Mailing Address - Fax:
Practice Address - Street 1:2318 SUNSET BLVD # 2A
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4716
Practice Address - Country:US
Practice Address - Phone:803-760-7490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health