Provider Demographics
NPI:1134657893
Name:CAROLINA PSYCHOTHERAPY & CONSULTING
Entity Type:Organization
Organization Name:CAROLINA PSYCHOTHERAPY & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSENTOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:843-422-8851
Mailing Address - Street 1:19 ROOKERY WAY
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2572
Mailing Address - Country:US
Mailing Address - Phone:843-422-8851
Mailing Address - Fax:843-342-3040
Practice Address - Street 1:90 MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-6615
Practice Address - Country:US
Practice Address - Phone:843-422-8851
Practice Address - Fax:843-342-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-25
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1215103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty