Healthcare Provider Details

I. General information

NPI: 1093627804
Provider Name (Legal Business Name): KATE SPYCHALSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001B MICHIGAN AVE
CHARLESTON SC
29418-2929
US

IV. Provider business mailing address

183 ROMNEY ST
CHARLESTON SC
29403-3757
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-2670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number18999
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: