Individual
MRS. LORA CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
204 PERRY WILEY WAY, CHESTERFIELD, SC 29709-5701
(843) 623-5080
(843) 623-5087
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
(843) 857-0111
(843) 857-0206
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5540
SC
101YP2500X
Professional Counselor
5540
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1545
—
SC
01
—
SCS392
MEDICARE
SC
Enumeration date
06/19/2013
Last updated
02/29/2024
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