Healthcare Provider Details

I. General information

NPI: 1750106787
Provider Name (Legal Business Name): SHEMCREEK PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 SCOTT ST
MOUNT PLEASANT SC
29464-4345
US

IV. Provider business mailing address

208 SCOTT ST
MOUNT PLEASANT SC
29464-4345
US

V. Phone/Fax

Practice location:
  • Phone: 843-607-9731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ELIZABETH ERVIN
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 843-607-9731