Healthcare Provider Details

I. General information

NPI: 1982915849
Provider Name (Legal Business Name): DONNA MARIA SALERNO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CARRIAGE LN BUILDING J
CHARLESTON SC
29407-6060
US

IV. Provider business mailing address

1 CARRIAGE LN BUILDING J
CHARLESTON SC
29407-6060
US

V. Phone/Fax

Practice location:
  • Phone: 843-573-5050
  • Fax: 843-573-5030
Mailing address:
  • Phone: 843-573-5050
  • Fax: 843-573-5030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5067
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5067
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: