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NPI Code Detail

MEDICARE: KATHLEEN NMI HEROLD MED, LPC

MEDICARE:   KATHLEEN NMI HEROLD  MED, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor1629SC

General Provider Information

NPI Number : 1053527689
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN NMI HEROLD MED, LPC
Provider Business Mailing Address
First Line : 2313 KING EDWARD DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-5604
Country : US
Telephone Number : 843-276-0694
Fax Number :
Provider Business Practice Location Address
First Line : 2313 KING EDWARD DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-5604
Country : US
Telephone Number : 843-276-0694
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 11/02/2009

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Directions to “ KATHLEEN NMI HEROLD MED, LPC” Practice Location

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