| Charleston Family Center, Llc | |
|
4 Carriage Ln Suite 100 Charleston SC 29407-6048 | |
| (843) 763-2222 | |
| (843) 766-5705 |
| Full Name | Charleston Family Center, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4 Carriage Ln, Charleston, South Carolina |
| Authorized Official Name and Position | Joan Berry (OFFICE MANAGER) |
| Authorized Official Contact | 8437632222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charleston Family Center, Llc 4 Carriage Ln Suite 100 Charleston SC 29407-6048 Ph: (843) 763-2222 | Charleston Family Center, Llc 4 Carriage Ln Suite 100 Charleston SC 29407-6048 Ph: (843) 763-2222 |
| NPI Number | 1619939873 |
|---|---|
| Provider Enumeration Date | 04/04/2006 |
| Last Update Date | 02/23/2008 |
| Medicare PECOS PAC ID | 3274521703 |
|---|---|
| Medicare Enrollment ID | O20040504000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619939873 | NPI | - | NPPES |
| GP3347 | Medicaid | SC | |
| DG5930 | Other | SC | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 6767 (South Carolina) | Primary |
| Provider Name | Robert H Payne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013060573 PECOS PAC ID: 5496744559 Enrollment ID: I20040512000600 |
| Provider Name | Harriet A Nason |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073666525 PECOS PAC ID: 4587653951 Enrollment ID: I20111202000321 |
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