Provider Demographics
NPI:1093150625
Name:MCCANN, VIRGINIA BROWN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:BROWN
Last Name:MCCANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 VON KOLNITZ RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3238
Mailing Address - Country:US
Mailing Address - Phone:843-849-2805
Mailing Address - Fax:
Practice Address - Street 1:855 VON KOLNITZ RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3238
Practice Address - Country:US
Practice Address - Phone:843-849-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional