Individual
KENDRA WOODY-SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CAC, SAP, NCC
Contact information
Practice address
6650 RIVERS AVE, SUITE 124, NORTH CHARLESTON, SC 29406-4809
(843) 475-9096
(866) 496-9934
Mailing address
1233 CREEK STONE WAY, HANAHAN, SC 29410-4739
(843) 437-6859
(866) 496-9934
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
09052613
SC
101YP2500X
Professional Counselor
Primary
5234
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09052613
CERTIFIED ADDICTION COUNSELOR
SC
01
—
13334
SUBSTANCE ABUSE PROFESSIONAL
SC
01
—
255933
NATIONAL CERTIFIED COUNSELOR
SC
01
—
5234
LICENSED PROFESSIONAL COUNSELOR
SC
Enumeration date
01/03/2011
Last updated
01/03/2011
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