Healthcare Provider Details

I. General information

NPI: 1831808112
Provider Name (Legal Business Name): OAK POINT PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 LIVE OAK DR
MOUNT PLEASANT SC
29464-4365
US

IV. Provider business mailing address

519 LIVE OAK DR
MOUNT PLEASANT SC
29464-4365
US

V. Phone/Fax

Practice location:
  • Phone: 843-971-8808
  • Fax: 843-971-9636
Mailing address:
  • Phone: 843-971-8808
  • Fax: 843-971-9636

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: ALLIE GRIMES
Title or Position: OWNER
Credential: MD
Phone: 843-971-8808