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NPI Code Detail

MEDICARE: CAMILLE BROWN CARPENTER

MEDICARE: CAMILLE BROWN CARPENTER
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
1101YM0800XMental Health CounselorSC

General Provider Information

NPI Number : 1588727689
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMILLE BROWN CARPENTER
Provider Business Mailing Address
First Line : 129 CLARK RIDGE RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29223-7044
Country : US
Telephone Number : 803-736-7827
Fax Number :
Provider Business Practice Location Address
First Line : 10 RICHLAND MEDICAL PARK DR
Second Line : TRIAGE
City : COLUMBIA
State : SC
Zip : 29203-6892
Country : US
Telephone Number : 803-898-8888
Fax Number : 803-343-0727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/08/2007

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Directions to “ CAMILLE BROWN CARPENTER ” Practice Location

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