Provider Demographics
NPI:1831632454
Name:ABRAMS-POPE, MARY (LPC-I)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ABRAMS-POPE
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ABRAMS
Other - Last Name:PACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:164 WACCAMAW MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-8903
Mailing Address - Country:US
Mailing Address - Phone:843-234-8084
Mailing Address - Fax:843-347-3959
Practice Address - Street 1:164 WACCAMAW MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8903
Practice Address - Country:US
Practice Address - Phone:843-234-8084
Practice Address - Fax:843-347-3959
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health