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Individual

MR. SPENCER WALKER JOSEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPC, CACII

Contact information

Practice address
1304-A AZALEA COU, MYRTLE BEACH, SC 29577
(843) 467-9538
Mailing address
3602 FARMINGTON PL, MYRTLE BEACH, SC 29579-7025
(843) 467-9538

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12080115
SC
101YM0800X
Mental Health Counselor
5536
SC
101YP2500X
Professional Counselor
Primary
5536
SC

Other

Enumeration date
08/06/2013
Last updated
08/06/2013
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