Healthcare Provider Details

I. General information

NPI: 1447036736
Provider Name (Legal Business Name): TEREASH CELESTE DAVIS KEITT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 MEETING ST
CHARLESTON SC
29401-3153
US

IV. Provider business mailing address

311 HOLLOW OAK DR UNIT A
SUMMERVILLE SC
29486-2689
US

V. Phone/Fax

Practice location:
  • Phone: 843-738-2360
  • Fax:
Mailing address:
  • Phone: 803-707-8552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12258
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: