Provider Demographics
NPI:1013013473
Name:LIFE ENRICHMENT COUNSELING CENTER INC
Entity type:Organization
Organization Name:LIFE ENRICHMENT COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:P
Authorized Official - Last Name:JOURDAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-761-7446
Mailing Address - Street 1:130 LAND O PINES CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461
Mailing Address - Country:US
Mailing Address - Phone:843-761-7446
Mailing Address - Fax:843-761-7446
Practice Address - Street 1:130 LAND O PINES CIRCLE
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461
Practice Address - Country:US
Practice Address - Phone:843-761-7446
Practice Address - Fax:843-761-7446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty