Healthcare Provider Details

I. General information

NPI: 1295387512
Provider Name (Legal Business Name): LOUMERA Y WRIGHT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2019
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3893 WATSON VIEW DR
AWENDAW SC
29429-6003
US

IV. Provider business mailing address

3893 WATSON VIEW DR
AWENDAW SC
29429-6003
US

V. Phone/Fax

Practice location:
  • Phone: 843-628-3298
  • Fax:
Mailing address:
  • Phone: 843-628-3298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9355
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: