Provider Demographics
NPI:1609203355
Name:BEDENBAUGH, LUCY B (LPC-I)
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:B
Last Name:BEDENBAUGH
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1809
Mailing Address - Country:US
Mailing Address - Phone:803-274-1567
Mailing Address - Fax:866-402-4518
Practice Address - Street 1:1624 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1809
Practice Address - Country:US
Practice Address - Phone:803-274-1567
Practice Address - Fax:866-402-4518
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6199101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor