Provider Demographics
NPI:1285717223
Name:TALLEY, STEPHEN EDWARD (LPC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:TALLEY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405A E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3062
Mailing Address - Country:US
Mailing Address - Phone:864-644-8251
Mailing Address - Fax:864-644-8253
Practice Address - Street 1:405A E 1ST AVE
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640
Practice Address - Country:US
Practice Address - Phone:864-644-8251
Practice Address - Fax:864-644-8253
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional