Provider Demographics
NPI:1366780132
Name:PRIOLEAU, ALMENA G (CACII)
Entity type:Individual
Prefix:
First Name:ALMENA
Middle Name:G
Last Name:PRIOLEAU
Suffix:
Gender:F
Credentials:CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 BRYANT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT STEPHEN
Mailing Address - State:SC
Mailing Address - Zip Code:29479-3253
Mailing Address - Country:US
Mailing Address - Phone:843-567-4867
Mailing Address - Fax:
Practice Address - Street 1:145 BRYANT DR
Practice Address - Street 2:
Practice Address - City:SAINT STEPHEN
Practice Address - State:SC
Practice Address - Zip Code:29479-3253
Practice Address - Country:US
Practice Address - Phone:843-567-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC09090419101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC09090419OtherCACII