Provider Demographics
NPI:1033359021
Name:LOWCOUNTRY BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:LOWCOUNTRY BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERT. ASSOC. BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:COOKE
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA
Authorized Official - Phone:303-619-1049
Mailing Address - Street 1:14 DUNNEMANN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3609
Mailing Address - Country:US
Mailing Address - Phone:303-619-1049
Mailing Address - Fax:843-727-0131
Practice Address - Street 1:14 DUNNEMANN AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-3609
Practice Address - Country:US
Practice Address - Phone:303-619-1049
Practice Address - Fax:843-727-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-08-2559103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty