Organization
ELITE COMMUNITY COUNSELING
Active
Other names
MSE Health and Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN SEAN ETHERIDGE LICENSE PROFESSIONAL (EXECUTIVE DIRECTOR)
(843) 672-7096
Entity
Organization
Contact information
Practice address
212 W MCGREGOR ST, PAGELAND, SC 29728-2137
(843) 672-7096
Mailing address
274 SEDGEWICK DR APT 101, FORT MILL, SC 29708-8170
(404) 655-9802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
6059
SC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/22/2015
Last updated
03/22/2025
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