Healthcare Provider Details

I. General information

NPI: 1902951510
Provider Name (Legal Business Name): KATHERINE ELIZABETH THARIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 BARNWELL HWY
ALLENDALE SC
29810-1905
US

IV. Provider business mailing address

1050 RIBAUT RD
BEAUFORT SC
29902-5400
US

V. Phone/Fax

Practice location:
  • Phone: 803-584-4636
  • Fax:
Mailing address:
  • Phone: 843-524-8899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5619
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: