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General NPI Number Information
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NPI Number | 1528962198
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Entity Type | Organization
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Legal Business Name | CALM HARBOR PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 171 CHURCH ST STE 340
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City | CHARLESTON
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State | SC
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Zip | 29401-3140
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Country | US
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Telephone | 843-459-7468
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 PROXIMITY DR APT 1314
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City | CHARLESTON
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State | SC
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Zip | 29414-7950
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Country | US
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Telephone | 803-818-0622
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACEY SUTHERLAND
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Credential | LPC
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Telephone | 803-818-0622
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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 |
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License Number State | NULL
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