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NPI Code Detail

MEDICARE: LOW COUNTRY PROFESSIONAL INTERVENTION SERVICES

MEDICARE: LOW COUNTRY PROFESSIONAL INTERVENTION SERVICES
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor
4103K00000XBehavior Analyst
5171R00000XInterpreter
6171M00000XCase Manager/Care Coordinator
7171W00000XContractor
8372500000XChore Provider
9374U00000XHome Health Aide
103747P1801XPersonal Care Attendant
113747A0650XAttendant Care Provider
12251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1417314329
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOW COUNTRY PROFESSIONAL INTERVENTION SERVICES
Provider Business Mailing Address
First Line : 4000 S. FABER PLACE DRIVE
Second Line : SUITE 300
City : NORTH CHARLESTON
State : SC
Zip : 29405-8587
Country : US
Telephone Number : 843-323-4310
Fax Number :
Provider Business Practice Location Address
First Line : 4000 S FABER PLACE DR
Second Line : SUITE 300
City : NORTH CHARLESTON
State : SC
Zip : 29405-8587
Country : US
Telephone Number : 843-323-4257
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. GIOVONNIA MCCALL
Credential :
Telephone Number : 843-323-4310
Provider Enumeration Date : 01/22/2016
Last Update Date : 07/07/2016

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Directions to “LOW COUNTRY PROFESSIONAL INTERVENTION SERVICES ” Practice Location

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