Provider Demographics
NPI:1083036271
Name:CHARLESTON COUNSELING
Entity Type:Organization
Organization Name:CHARLESTON COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:SINIUK
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:843-412-5207
Mailing Address - Street 1:887 JOHNNIE DODDS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3154
Mailing Address - Country:US
Mailing Address - Phone:843-956-6998
Mailing Address - Fax:843-956-6997
Practice Address - Street 1:887 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3154
Practice Address - Country:US
Practice Address - Phone:843-956-6998
Practice Address - Fax:843-956-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty