Healthcare Provider Details

I. General information

NPI: 1306510961
Provider Name (Legal Business Name): CHRISTINA ANN CARTAGENA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MULBERRY ST W
HAMPTON SC
29924-3416
US

IV. Provider business mailing address

6939 SC HIGHWAY 37
WILLISTON SC
29853-4289
US

V. Phone/Fax

Practice location:
  • Phone: 803-989-3542
  • Fax: 803-887-6091
Mailing address:
  • Phone: 803-989-3542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8591
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8591
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: