Healthcare Provider Details

I. General information

NPI: 1346876240
Provider Name (Legal Business Name): CATHERINE MEWBORN WOOD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

IV. Provider business mailing address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

V. Phone/Fax

Practice location:
  • Phone: 843-948-8070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3712
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1929
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: