Provider Demographics
NPI:1033169834
Name:OBIKA, AUSTIN
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:
Last Name:OBIKA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:AUSTIN
Other - Middle Name:
Other - Last Name:CHUKAKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:SWCMHC, 215 N. MAGNOLIA ST.
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-1946
Mailing Address - Country:US
Mailing Address - Phone:803-775-9364
Mailing Address - Fax:803-773-6615
Practice Address - Street 1:215 COMMERCE ST
Practice Address - Street 2:SWCMHC/CLARENDON COUNTY MENTAL HEALTH CLINIC
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-2638
Practice Address - Country:US
Practice Address - Phone:803-495-2124
Practice Address - Fax:803-435-8113
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health