Healthcare Provider Details

I. General information

NPI: 1528962198
Provider Name (Legal Business Name): CALM HARBOR PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 CHURCH ST STE 340
CHARLESTON SC
29401-3140
US

IV. Provider business mailing address

2020 PROXIMITY DR APT 1314
CHARLESTON SC
29414-7950
US

V. Phone/Fax

Practice location:
  • Phone: 843-459-7468
  • Fax:
Mailing address:
  • Phone: 803-818-0622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: STACEY SUTHERLAND
Title or Position: OWNER
Credential: LPC
Phone: 803-818-0622