Healthcare Provider Details

I. General information

NPI: 1396402095
Provider Name (Legal Business Name): BROOKE PAULSON AHERNE LCPC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 SATURDAY RD
MOUNT PLEASANT SC
29464-2695
US

IV. Provider business mailing address

54 SATURDAY RD
MOUNT PLEASANT SC
29464-2695
US

V. Phone/Fax

Practice location:
  • Phone: 843-793-7285
  • Fax:
Mailing address:
  • Phone: 843-793-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC14369
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC9274
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: