Healthcare Provider Details

I. General information

NPI: 1215062823
Provider Name (Legal Business Name): ADRIAN NOVIT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 ASHLEY TOWN CENTER DR STE 203B
CHARLESTON SC
29414-5678
US

IV. Provider business mailing address

3030 ASHLEY TOWN CENTER DR STE 203B
CHARLESTON SC
29414-5678
US

V. Phone/Fax

Practice location:
  • Phone: 843-410-8448
  • Fax: 843-735-7323
Mailing address:
  • Phone: 843-410-8448
  • Fax: 843-735-7323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number756
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number756
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number756
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number756
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: