Provider Demographics
NPI:1952438376
Name:MT.HEBRON PASTORAL COUNSELING SERVICE
Entity type:Organization
Organization Name:MT.HEBRON PASTORAL COUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARWICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LMFT
Authorized Official - Phone:803-791-0495
Mailing Address - Street 1:3050 LEAPHART RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3000
Mailing Address - Country:US
Mailing Address - Phone:803-791-0495
Mailing Address - Fax:803-791-1958
Practice Address - Street 1:3050 LEAPHART RD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3000
Practice Address - Country:US
Practice Address - Phone:803-791-0495
Practice Address - Fax:803-791-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC66941041C0700X
SC4752101YP2500X
SC2754101YP2500X
SC217106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty