Provider Demographics
NPI:1861711665
Name:WELLS, DENNIS DALE (NCC, LPC, LPCS)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:DALE
Last Name:WELLS
Suffix:
Gender:M
Credentials:NCC, LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-1541
Mailing Address - Country:US
Mailing Address - Phone:803-318-5400
Mailing Address - Fax:
Practice Address - Street 1:711 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-1541
Practice Address - Country:US
Practice Address - Phone:803-318-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional