Healthcare Provider Details

I. General information

NPI: 1568392223
Provider Name (Legal Business Name): MICHELLE ANN PRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SAM RITTENBERG BLVD STE 3009
CHARLESTON SC
29407-4631
US

IV. Provider business mailing address

26 BOONE AVE
GOOSE CREEK SC
29445-6002
US

V. Phone/Fax

Practice location:
  • Phone: 843-608-8822
  • Fax: 843-654-4850
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10262
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: