Provider Demographics
NPI:1104183094
Name:GREER HAM, HEATHER MELISSA (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MELISSA
Last Name:GREER HAM
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51773
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-1773
Mailing Address - Country:US
Mailing Address - Phone:843-452-7868
Mailing Address - Fax:843-875-3959
Practice Address - Street 1:716 W FRONT ST
Practice Address - Street 2:
Practice Address - City:LINCOLNVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-7112
Practice Address - Country:US
Practice Address - Phone:843-832-1086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5384101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor