Provider Demographics
NPI:1063135648
Name:PARK CIRCLE COUNSELING
Entity type:Organization
Organization Name:PARK CIRCLE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-732-0007
Mailing Address - Street 1:P.O. BOX 21806
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29413
Mailing Address - Country:US
Mailing Address - Phone:843-732-0007
Mailing Address - Fax:
Practice Address - Street 1:6296 RIVERS AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:843-732-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health