Provider Demographics
NPI:1497646764
Name:LEWIS, VIVIAN SHULER (LPCA)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:SHULER
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MINUS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:SC
Mailing Address - Zip Code:29477-2340
Mailing Address - Country:US
Mailing Address - Phone:843-560-2353
Mailing Address - Fax:
Practice Address - Street 1:1752 JESSAMINE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5270
Practice Address - Country:US
Practice Address - Phone:843-560-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9075101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional