Organization
RADICAL TRANSFORMATIONS COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANA LENETTE TUCKER MA,CACII, LPC,MAC (CLINCIAL COUNSELOR)
(803) 727-0658
Entity
Organization
Contact information
Practice address
630 OLD ORANGEBURG RD APT A, LEXINGTON, SC 29073-6927
(803) 727-0658
Mailing address
PO BOX 8781, COLUMBIA, SC 29202-8781
(803) 727-0658
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6111
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1559
—
SC
Enumeration date
06/12/2017
Last updated
06/11/2019
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