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Mrs. Laniece Leach-ajavon
Mental Health Counselor in Conway, South Carolina
NPI 1790164192

Laniece Leach-ajavon is a Mental Health Counselor based in Conway, SC and is specialized in Mental Health. Laniece Leach-ajavon practices in Conway, SC. The NPI Number for Laniece Leach-ajavon is 1790164192 and holds a License No. (South Carolina).

The current practice location address for Laniece Leach-ajavon is 164 Waccamaw Medical Park Dr, Conway, SC and can be reached out via phone at 843-347-5060 and via fax at 843-347-3959. You can also correspond with Laniece Leach-ajavon through the mailing address at 164 WACCAMAW MEDICAL PARK DR, CONWAY, SC - 29526-8903 (mailing address contact number: 843-347-5060).

Location: 164 Waccamaw Medical Park Dr, Conway, SC, 29526-8903
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790164192
Provider Name
Laniece Leach-ajavon
Credential
Provider Entity Type
Individual
Gender
Female
Address
164 Waccamaw Medical Park Dr, Conway, SC, 29526-8903
Phone Number
843-347-5060
Fax Number
843-347-3959
Provider Enumeration Date
05/19/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
13449079 01 NC CAQH
institution
Provider Business Practice Location Address Details
Address
164 Waccamaw Medical Park Dr
City
Conway
State
South Carolina
Zip
29526-8903
Phone Number
843-347-5060
Fax Number
843-347-3959
person
Provider Business Mailing Address Details
Address
164 Waccamaw Medical Park Dr
City
Conway
State
South Carolina
Zip
29526-8903
Phone Number
843-347-5060
Fax Number
843-347-3959
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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