Provider Demographics
NPI:1467874305
Name:PARAKLETOS333
Entity type:Organization
Organization Name:PARAKLETOS333
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:843-259-9433
Mailing Address - Street 1:173 MARY ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3355
Mailing Address - Country:US
Mailing Address - Phone:843-259-9433
Mailing Address - Fax:
Practice Address - Street 1:3 GAMECOCK AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3378
Practice Address - Country:US
Practice Address - Phone:843-640-6882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5604101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty