Organization
RAVENEL THERAPEUTIC COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY D RAVENEL LPC (LICENSED PROFESSIONAL COUNSELOR)
(843) 709-7707
Entity
Organization
Contact information
Practice address
29 GAMECOCK AVE STE 100, CHARLESTON, SC 29407-3366
(843) 709-7707
(843) 507-8739
Mailing address
4179 DAVISON RD, RAVENEL, SC 29470-5307
(843) 408-3214
(843) 507-8739
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6482
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1772
—
SC
Enumeration date
09/19/2017
Last updated
09/19/2017
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