Provider Demographics
NPI:1336426253
Name:AHNTHOLZ, ELISABETH LOUISE (LPCC)
Entity Type:Individual
Prefix:MISS
First Name:ELISABETH
Middle Name:LOUISE
Last Name:AHNTHOLZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 HERON MARSH CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-7728
Mailing Address - Country:US
Mailing Address - Phone:843-991-7937
Mailing Address - Fax:843-559-6923
Practice Address - Street 1:3905 HERON MARSH CIR
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-7728
Practice Address - Country:US
Practice Address - Phone:843-991-7937
Practice Address - Fax:843-559-6923
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0122571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional