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General NPI Number Information
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NPI Number | 1629436480
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Entity Type | Individual
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Provider Name | REGINA LEE-CARTER
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Gender | Female
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 402 HAYNSWORTH ST
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City | SUMTER
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State | SC
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Zip | 29150-4008
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Country | US
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Telephone | 803-607-8058
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Fax | 803-879-4605
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Provider Business Mailing Address
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Address Line | 531 OXFORD ST STE C-6
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City | SUMTER
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State | SC
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Zip | 29150-3300
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Country | US
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Telephone | 803-607-8058
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Fax | 803-879-4605
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 10678
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License Number State | SC
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