Provider Demographics
NPI:1285103713
Name:FAMILY RESTORATION COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:FAMILY RESTORATION COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-688-2618
Mailing Address - Street 1:110B HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3226
Mailing Address - Country:US
Mailing Address - Phone:864-688-2618
Mailing Address - Fax:864-688-2766
Practice Address - Street 1:110B HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3226
Practice Address - Country:US
Practice Address - Phone:864-688-2618
Practice Address - Fax:864-688-2766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1437296480OtherNPI