Provider Demographics
NPI:1659672806
Name:RONNIE MCCARRELL
Entity Type:Organization
Organization Name:RONNIE MCCARRELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCCARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-283-0637
Mailing Address - Street 1:301 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4022
Mailing Address - Country:US
Mailing Address - Phone:864-283-0637
Mailing Address - Fax:864-283-0638
Practice Address - Street 1:301 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4022
Practice Address - Country:US
Practice Address - Phone:864-283-0637
Practice Address - Fax:864-283-0638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty