Individual
TYLER EISENHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414
(843) 852-4100
(843) 573-2393
Mailing address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
(843) 573-2393
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
6376
SC
101YM0800X
Mental Health Counselor
6376
SC
101YP2500X
Professional Counselor
Primary
6868
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
01
—
6376
LLR
SC
Enumeration date
07/05/2016
Last updated
05/25/2018
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