Individual provider · Type 1 NPI

Linda Cooper Lack, PhD

Professional Counselor · Myrtle Beach, SC

NPI number 1043357064 Active

Practice location

1371 Wading Bird Lane
Myrtle Beach, SC 29577

Call (843) 448-6516 Map

Mailing address

PO Box 70478
Myrtle Beach, SC 29572-0026

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X1776 (SC)

Professional Counselor: Definition to come...

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About NPI 1043357064

Linda Cooper Lack, PhD's National Provider Identifier is 1043357064, issued on Jan 31, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Myrtle Beach, SC. The record was last updated on Jul 8, 2007.