Healthcare Provider Details

I. General information

NPI: 1952517229
Provider Name (Legal Business Name): BARRIER ISLANDS PSYCHIATRY P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 ASHLEY RIVER RD
CHARLESTON SC
29407-5902
US

IV. Provider business mailing address

1620 ASHLEY RIVER RD
CHARLESTON SC
29407-5983
US

V. Phone/Fax

Practice location:
  • Phone: 843-556-8177
  • Fax: 843-571-2742
Mailing address:
  • Phone: 843-556-8177
  • Fax: 843-571-2742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22098
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1981
License Number StateSC

VIII. Authorized Official

Name: DR. CONSTANCE J. ALEXANDER
Title or Position: OWNER
Credential: M. D.
Phone: 843-556-8177