Individual
MR. DEONTAY ADRAIN WINCHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
500 S KAMINSKI ST STE 213, GEORGETOWN, SC 29440-3435
(843) 932-7217
Mailing address
2829 ETON ST, MYRTLE BEACH, SC 29579-6711
(843) 202-5789
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
13807
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
13807
SC
101YM0800X
Mental Health Counselor
Primary
13807
SC
101YP2500X
Professional Counselor
13807
SC
102L00000X
Psychoanalyst
13807
SC
102X00000X
Poetry Therapist
13807
SC
104100000X
Social Worker
13807
SC
1041C0700X
Clinical Social Worker
13807
SC
106H00000X
Marriage & Family Therapist
13807
SC
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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