Provider Demographics
NPI:1851139216
Name:SARTAIN, SUSANNA BOND (MA, LPCA, NCC)
Entity type:Individual
Prefix:
First Name:SUSANNA
Middle Name:BOND
Last Name:SARTAIN
Suffix:
Gender:F
Credentials:MA, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CARRIAGE LN BLDG E201
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6060
Mailing Address - Country:US
Mailing Address - Phone:843-580-4288
Mailing Address - Fax:
Practice Address - Street 1:1 CARRIAGE LN BLDG E201
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6060
Practice Address - Country:US
Practice Address - Phone:843-580-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCOU.9024PCI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional