Organization
POTENTIAL COUNSELING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELASHA LAVONE LEARY M.A, GCDF (EXECUTIVE DIRECTOR)
(843) 283-4132
Entity
Organization
Contact information
Practice address
8377 HUNTINGTON CT, CONWAY, SC 29527-7989
(843) 283-4132
Mailing address
8377 HUNTINGTON CT, PO BOX 1376, CONWAY, SC 29527-7989
(843) 283-4132
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
SC
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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