Provider Demographics
NPI:1871605162
Name:MARRIAGE-FAMILY & CHILD COUNSELING
Entity type:Organization
Organization Name:MARRIAGE-FAMILY & CHILD COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HIATT
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:843-669-3323
Mailing Address - Street 1:2145B HOFFMEYER RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4015
Mailing Address - Country:US
Mailing Address - Phone:843-669-3323
Mailing Address - Fax:843-661-6705
Practice Address - Street 1:2145B HOFFMEYER RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4015
Practice Address - Country:US
Practice Address - Phone:843-669-3323
Practice Address - Fax:843-661-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1033101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty