Organization
SOUTH CAROLINA ONLINE COUNSELING AND GROUP THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGH DIOTALEVI LISW-CP (ADMINISTRATOR)
(843) 636-5017
Entity
Organization
Contact information
Practice address
61 RIVERWALK BLVD STE H, RIDGELAND, SC 29936-3252
(843) 636-5017
(843) 206-0256
Mailing address
61 RIVERWALK BLVD STE H, RIDGELAND, SC 29936-3252
(843) 636-5017
(843) 206-0256
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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