Provider Demographics
NPI:1619513983
Name:BEACON OF HOPE COUNSELING CENTER, L.L.C.
Entity Type:Organization
Organization Name:BEACON OF HOPE COUNSELING CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-524-8346
Mailing Address - Street 1:808 CULLYBACKEY DR APT 106
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5690
Mailing Address - Country:US
Mailing Address - Phone:803-524-8346
Mailing Address - Fax:
Practice Address - Street 1:3490 SALUDA RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7260
Practice Address - Country:US
Practice Address - Phone:803-524-8346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health