Provider Demographics
NPI:1831415900
Name:RICHARD, ELISE (LPC, LPCS, LAC)
Entity type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:
Last Name:RICHARD
Suffix:
Gender:F
Credentials:LPC, LPCS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S AINSDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7365
Mailing Address - Country:US
Mailing Address - Phone:843-870-0278
Mailing Address - Fax:
Practice Address - Street 1:3030 ASHLEY TOWN CENTER DR STE 203B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5678
Practice Address - Country:US
Practice Address - Phone:843-870-0278
Practice Address - Fax:843-282-7817
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-14
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SC5154101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health