Provider Demographics
NPI:1912952904
Name:COUNSELING CENTER OF CHARLESTON INC
Entity type:Organization
Organization Name:COUNSELING CENTER OF CHARLESTON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PRUE
Authorized Official - Middle Name:MCGEE
Authorized Official - Last Name:HAMMETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:M DIV
Authorized Official - Phone:843-856-8975
Mailing Address - Street 1:1041 JOHNNIE DODDS BLVD
Mailing Address - Street 2:STE 5C
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6156
Mailing Address - Country:US
Mailing Address - Phone:843-856-8975
Mailing Address - Fax:843-856-8994
Practice Address - Street 1:1041 JOHNNIE DODDS BLVD
Practice Address - Street 2:STE 5C
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6156
Practice Address - Country:US
Practice Address - Phone:843-856-8975
Practice Address - Fax:843-856-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2395103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty