Lewis, Kellie Mcdougall

Lewis, Kellie Mcdougall is an sole proprietor health care provider with primary practice located at 9403 Highway 707 Ste B , Myrtle Beach SC 29588-7758. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Lewis, Kellie Mcdougall can be contacted via phone (843) 273-0077.

Contact Information

Primary practice address
9403 Highway 707 Ste B Myrtle Beach SC 29588-7758
Phone: (843) 273-0077
Fax: (843) 273-0075
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X AC0396 Maryland
Behavioral Health & Social Service Providers / Clinical 1041C0700X 10157 South Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X 14474 Maryland

Profile Details

NPI number 1265421937
LBN Legal business name Lewis, Kellie Mcdougall
Credentials L.I.S.W-CP, CAC-AD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2005
Last updated Jan 31st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265421937 NPPES
South Carolina Other C916 GROUP REAL COUNSELING LLC
South Carolina Other SC1938C916 GROUP REAL COUNSELING LLC

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