Provider Demographics
NPI:1447988001
Name:HOMEYER, PAUL (LPC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HOMEYER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 ROUNDUP DR
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29010-1042
Mailing Address - Country:US
Mailing Address - Phone:817-690-8180
Mailing Address - Fax:
Practice Address - Street 1:228 ROUNDUP DR
Practice Address - Street 2:
Practice Address - City:BISHOPVILLE
Practice Address - State:SC
Practice Address - Zip Code:29010-1042
Practice Address - Country:US
Practice Address - Phone:817-690-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8367101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor