Healthcare Provider Details

I. General information

NPI: 1063334357
Provider Name (Legal Business Name): LOLITA BATTLE LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SHANNON RD
WALTERBORO SC
29488-2759
US

IV. Provider business mailing address

205 SHANNON RD
WALTERBORO SC
29488-2759
US

V. Phone/Fax

Practice location:
  • Phone: 904-607-2425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10937
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: