John Ray Addison, LPC

Individual provider Active NPI Professional Counselor · Seneca, SC

NPI 1043589997 · NPPES record last updated Dec 21, 2011

Key facts

NPI
1043589997
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
1844 (SC)
Practice address
530 By Pass 123
Suite E2
Seneca, SC 29678-0859
Phone
(864) 882-7600
Fax
(864) 882-7631
NPI assigned
Dec 21, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Counseling Center J. Ray Addison PH.D. PRT Et Al Professional Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1844 SC Yes

Addresses

Primary practice location

530 By Pass 123
Suite E2
Seneca, SC 29678-0859

Mailing address

PO Box 1105
Clemson, SC 29633-1105
Phone (864) 882-7600

Other providers in Seneca, SC

All providers in Seneca, SC · Professional Counselor in South Carolina

Sources for this page

Verify at the official NPI Registry.