Provider Demographics
NPI:1174018378
Name:REEP, SUSAN CAMBERLYN (BS, CACP)
Entity Type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:CAMBERLYN
Last Name:REEP
Suffix:
Gender:F
Credentials:BS, CACP
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:CAMBERLYN
Other - Last Name:REEP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, CACP
Mailing Address - Street 1:2470 MALL DR UNIT CD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6514
Mailing Address - Country:US
Mailing Address - Phone:843-207-4721
Mailing Address - Fax:843-207-4727
Practice Address - Street 1:2470 MALL DR UNIT CD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6514
Practice Address - Country:US
Practice Address - Phone:843-207-4721
Practice Address - Fax:843-207-4727
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)