Healthcare Provider Details

I. General information

NPI: 1518895549
Provider Name (Legal Business Name): GRAYSON INSLEY BAINBRIDGE LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BELLE HALL PKWY UNIT 102
MT PLEASANT SC
29464-8322
US

IV. Provider business mailing address

1410 SHUCKER CIR APT 403
MT PLEASANT SC
29464-4968
US

V. Phone/Fax

Practice location:
  • Phone: 843-225-0567
  • Fax: 843-225-0568
Mailing address:
  • Phone: 714-603-9476
  • Fax: 843-225-0568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8893
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: