MEDICARE: LAKESIDE CENTER FOR OCD & ANXIETY, LLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1346066099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKESIDE CENTER FOR OCD & ANXIETY, LLC

Provider Business Mailing Address
First Line	:	116 ARTISAN CT
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-6910
Country	:	US
Telephone Number	:	803-728-1168
Fax Number	:	803-728-3069

Provider Business Practice Location Address
First Line	:	116 ARTISAN CT
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-6910
Country	:	US
Telephone Number	:	803-728-1168
Fax Number	:	803-728-3069

Authorized Official
Title or Position	:	ITS MEMBER-MANAGER
Name	:	NORA B SINCLAIR
Credential	:	LPC
Telephone Number	:	803-728-1168

Provider Enumeration Date	:	11/26/2024
Last Update Date	:	03/10/2026

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