Provider Demographics
NPI:1104513217
Name:WELLS, CHRISTOPHER (MS, LPC-A)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WELLS
Suffix:
Gender:M
Credentials:MS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 GOODLET CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8329
Mailing Address - Country:US
Mailing Address - Phone:843-452-4287
Mailing Address - Fax:
Practice Address - Street 1:890 JOHNNIE DODDS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6129
Practice Address - Country:US
Practice Address - Phone:843-884-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health