Organization
MACON CHANGES PROFESSIONAL COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY MACON LPC, LAC, CRC (OWNER)
(803) 223-9010
Entity
Organization
Contact information
Practice address
108 INVIEW RD, WEST COLUMBIA, SC 29169-5234
(803) 223-9010
Mailing address
210 PINE BLUFF RD., COLUMBIA, SC 29229
(803) 509-2844
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6702
SC
Other
Enumeration date
09/01/2018
Last updated
09/01/2018
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