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1 Carriage Ln Ste 102 Charleston SC 29407-6060 | |
| (978) 503-9147 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1 Carriage Ln Ste 102, Charleston, South Carolina |
| Authorized Official Name and Position | Clara Couch (OWNER) |
| Authorized Official Contact | 8437905273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 Carriage Ln Ste 102 Charleston SC 29407-6060 Ph: () - | 1 Carriage Ln Ste 102 Charleston SC 29407-6060 Ph: (978) 503-9147 |
| NPI Number | 1457183527 |
|---|---|
| Provider Enumeration Date | 08/16/2024 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457183527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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