MEDICARE: LOWCOUNTRY COUNSELING SERVICES

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	251S00000X	Community/Behavioral Health Agency	735843	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669876488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWCOUNTRY COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	1107 RIVER RD
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-8703
Country	:	US
Telephone Number	:	843-697-3748
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 RIVER RD
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-8703
Country	:	US
Telephone Number	:	843-697-3748
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PARKE SMITH
Credential	:	LPC
Telephone Number	:	843-697-3748

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	10/22/2014

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Directions to “LOWCOUNTRY COUNSELING SERVICES ” Practice Location

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