Provider Demographics
NPI:1518262138
Name:REAL COUNSELING, LLC
Entity Type:Organization
Organization Name:REAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR SUP
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:EVERHART
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:843-273-0077
Mailing Address - Street 1:PO BOX 31447
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-0025
Mailing Address - Country:US
Mailing Address - Phone:843-273-0077
Mailing Address - Fax:843-273-0075
Practice Address - Street 1:6215 HIGHWAY 707
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7362
Practice Address - Country:US
Practice Address - Phone:843-273-0077
Practice Address - Fax:843-273-0075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5204101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C916OtherMEDICARE PTAN
C916OtherMEDICARE PTAN