Provider Demographics
NPI:1619507241
Name:ANCHOR OF HOPE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:ANCHOR OF HOPE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-469-1252
Mailing Address - Street 1:4108 CAROLINA COMMERCIAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4223
Mailing Address - Country:US
Mailing Address - Phone:843-469-1252
Mailing Address - Fax:
Practice Address - Street 1:3826 MAYPOP CIRCLE 417
Practice Address - Street 2:3826 MAYPOP CIRCLE 417
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-1410
Practice Address - Country:US
Practice Address - Phone:843-469-1252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty