Healthcare Provider Details

I. General information

NPI: 1033477203
Provider Name (Legal Business Name): SARAH ROSE HUDGINS LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E BAY ST STE 404
CHARLESTON SC
29401-2637
US

IV. Provider business mailing address

215 E BAY ST STE 404
CHARLESTON SC
29401-2637
US

V. Phone/Fax

Practice location:
  • Phone: 843-376-6157
  • Fax:
Mailing address:
  • Phone: 843-376-6157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5400
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: