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General NPI Number Information
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NPI Number | 1043486079
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Entity Type | Organization
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Legal Business Name | OCEAN SUN COUNSELING CENTER
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 815 SAVANNAH HWY STE 202
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City | CHARLESTON
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State | SC
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Zip | 29407-7351
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Country | US
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Telephone | 843-556-4541
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Fax | 843-556-1599
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Provider Business Mailing Address
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Address Line | 74 HOSPITALITY ST
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City | MT PLEASANT
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State | SC
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Zip | 29464-2696
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Country | US
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Telephone | 843-216-6857
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Fax | 843-556-1599
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Authorized Official
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Title or Position | CONSULTANT
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Name | DR. JAMES EDWARD MCKINNEY
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Credential | MD
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Telephone | 843-556-4541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 16823
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License Number State | SC
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