Healthcare Provider Details

I. General information

NPI: 1104296102
Provider Name (Legal Business Name): CLAIRE CARPENTER PHILLIPS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLAIRE ELIZABETH CARPENTER

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 TAYLOR ST STE 6J
COLUMBIA SC
29201-2930
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-4300
  • Fax: 803-434-4351
Mailing address:
  • Phone: 864-695-6697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1358
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1358
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: