MEDICARE: MRS. CHRISTINA E DOUCETTE M.A., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6466	SC

General Provider Information

NPI Number	:	1336526128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINA E DOUCETTE M.A., LPC

Provider Business Mailing Address
First Line	:	1054 ANNA KNAPP BLVD
Second Line	:	#2D
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3163
Country	:	US
Telephone Number	:	843-754-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1054 ANNA KNAPP BLVD
Second Line	:	#2D
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3163
Country	:	US
Telephone Number	:	843-754-3439
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2015
Last Update Date	:	07/27/2022

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