Provider Demographics
NPI:1871779900
Name:GARLAND, JOHN LEE (EDS,LPC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LEE
Last Name:GARLAND
Suffix:
Gender:M
Credentials:EDS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MAYFAIR PL
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-2117
Mailing Address - Country:US
Mailing Address - Phone:803-370-3720
Mailing Address - Fax:
Practice Address - Street 1:410 S HERLONG AVE
Practice Address - Street 2:SUITE 4-6
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-8349
Practice Address - Country:US
Practice Address - Phone:803-370-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4050101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional