Organization
DIVINE INTERVENTION COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAPHAEL PATRICK EKONG LPC (LICENSED PROFESSIONAL COUNSELOR)
(843) 642-1492
Entity
Organization
Contact information
Practice address
3236 LANDMARK DRIVE, SUITE 124, NORTH CHARLESTON, SC 29418
(843) 642-1492
(843) 225-9124
Mailing address
3236 LANDMARK DRIVE, SUITE 124, NORTH CHARLESTON, SC 29418
(843) 642-1492
(843) 225-9124
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5026
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1071
—
SC
Enumeration date
12/03/2010
Last updated
12/03/2010
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