Individual
CHALLIS EVELYN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
141 MCDONALD CT, MYRTLE BEACH, SC 29588-6134
(843) 294-0646
(843) 294-0318
Mailing address
141 MCDONALD CT, MYRTLE BEACH, SC 29588-6134
(843) 294-0646
(843) 294-0318
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7920
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7920
LPC.7920 PC
SC
Enumeration date
08/13/2021
Last updated
08/13/2021
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