Healthcare Provider Details

I. General information

NPI: 1972408185
Provider Name (Legal Business Name): MARSH LIGHT ASSESSMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1 CARRIAGE LN BLDG B
CHARLESTON SC
29407-6060
US

IV. Provider business mailing address

1 CARRIAGE LN BLDG B
CHARLESTON SC
29407-6060
US

V. Phone/Fax

Practice location:
  • Phone: 843-270-9840
  • Fax:
Mailing address:
  • Phone: 843-270-9840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARA PUCKETT
Title or Position: OWNER/MANAGING MEMBER
Credential: ED.S, LPES
Phone: 843-270-9840