Provider Demographics
NPI:1598252199
Name:LAND, CHANA ASHLAN (LPC, LPCS)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:ASHLAN
Last Name:LAND
Suffix:
Gender:F
Credentials:LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 OLD CLEMSON HIGHWAY SUITE E, #111
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-8029
Mailing Address - Country:US
Mailing Address - Phone:864-952-1219
Mailing Address - Fax:
Practice Address - Street 1:530 BY PASS 123 STE E2
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678
Practice Address - Country:US
Practice Address - Phone:864-952-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional