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General NPI Number Information
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NPI Number | 1649733700
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Entity Type | Organization
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Legal Business Name | LOWCOUNTRY THERAPY OF SC LLC
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Dates
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Enumeration Date | 04/07/2019
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Last Update Date | 04/07/2019
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Provider Practice Location Address
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Address Line | 208 W 7TH NORTH ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6621
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Country | US
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Telephone | 843-557-2667
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Fax |
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Provider Business Mailing Address
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Address Line | 119 KING CHARLES CIR
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City | SUMMERVILLE
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State | SC
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Zip | 29485-3408
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Country | US
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Telephone | 843-822-5837
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Fax | 855-435-6230
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. NICHOLAS KIERPIEC
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Credential |
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Telephone | 843-557-2667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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