Provider Demographics
NPI:1265800908
Name:SLOAN, TANYA (LPC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:SLOAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 REMOUNT RD # 1C
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-3320
Mailing Address - Country:US
Mailing Address - Phone:843-695-8454
Mailing Address - Fax:843-804-9101
Practice Address - Street 1:1495 REMOUNT RD # 1C
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-3320
Practice Address - Country:US
Practice Address - Phone:843-695-8454
Practice Address - Fax:843-804-9101
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7551101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional