Tricounty Behavioral Health, LLC
Thank you for choosing Tricounty Behavioral Health. Please input information from you statement below. You will receive a receipt via email after your payment is processed. Please contact billing at firstname.lastname@example.org or 843-284-3192 with questions or issues.
Doctor or Provider's Name
This will be letters or numbers located in the field labeled Account Number on your statement.
Email Address for Receipt:
( X )
Credit/Debit Card Information:
Credit Card Number
Should be Empty: