Healthcare Provider Details

I. General information

NPI: 1427261783
Provider Name (Legal Business Name): CHARLESTON PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9929 F UNIVERSITY BLVD 2 B
CHARLESTON SC
29406
US

IV. Provider business mailing address

9929 F UNIVERSITY BLVD 2 B
CHARLESTON SC
29406
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-9800
  • Fax:
Mailing address:
  • Phone: 843-572-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number301
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9614
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number17805
License Number StateSC

VIII. Authorized Official

Name: BRIAN WEST
Title or Position: PRESIDENT
Credential:
Phone: 843-572-9800