Provider Demographics
NPI:1952524647
Name:STROUD, BILLIE KERR (LPCS)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:KERR
Last Name:STROUD
Suffix:
Gender:
Credentials:LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130A WHITEFORD WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7617
Mailing Address - Country:US
Mailing Address - Phone:803-808-1800
Mailing Address - Fax:803-808-1164
Practice Address - Street 1:130A WHITEFORD WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7617
Practice Address - Country:US
Practice Address - Phone:803-808-1800
Practice Address - Fax:803-808-1164
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5194103TC1900X
SC4735390200000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC405127Medicaid
SC3343Medicare ID - Type Unspecified