Healthcare Provider Details

I. General information

NPI: 1720770431
Provider Name (Legal Business Name): CHARLESTON CONFIDENT CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 GARDEN LILY LN
SUMMERVILLE SC
29485-9229
US

IV. Provider business mailing address

180 GARDEN LILY LN
SUMMERVILLE SC
29485-9229
US

V. Phone/Fax

Practice location:
  • Phone: 843-640-5379
  • Fax:
Mailing address:
  • Phone: 843-640-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIERA WALSH
Title or Position: OWNER/CEO
Credential: CD(DONA), CLC, B.S.
Phone: 843-640-5379