Healthcare Provider Details

I. General information

NPI: 1437556966
Provider Name (Legal Business Name): NINA SCHROTH LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MEGANS BAY LN
CHARLESTON SC
29492-8512
US

IV. Provider business mailing address

301 MEGANS BAY LN
CHARLESTON SC
29492-8512
US

V. Phone/Fax

Practice location:
  • Phone: 240-481-5057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9621
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: