Lake Psychological Services, Llc | |
115 Atrium Way Suite 221 Columbia SC 29223-6383 | |
(803) 699-8887 | |
(803) 699-8824 |
Full Name | Lake Psychological Services, Llc |
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Speciality | Psychologist - Clinical |
Location | 115 Atrium Way, Columbia, South Carolina |
Authorized Official Name and Position | Karen Downs Lake (OWNER) |
Authorized Official Contact | 8036998887 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake Psychological Services, Llc Po Box 707 Blythewood SC 29016-0707 Ph: (803) 699-8887 | Lake Psychological Services, Llc 115 Atrium Way Suite 221 Columbia SC 29223-6383 Ph: (803) 699-8887 |
NPI Number | 1578986923 |
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Provider Enumeration Date | 01/21/2014 |
Last Update Date | 01/23/2014 |
Identifier | Type | State | Issuer |
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1578986923 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 690 (South Carolina) | Primary |
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