Provider Demographics
NPI:1194195560
Name:LOWCOUNTRY PROFESSIONAL COUNSELORS LLC
Entity Type:Organization
Organization Name:LOWCOUNTRY PROFESSIONAL COUNSELORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAMISONVOID
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:910-641-2966
Mailing Address - Street 1:290 NEW RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-4406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:843-374-3003
Practice Address - Street 1:290 NEW RIVER PKWY
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-4406
Practice Address - Country:US
Practice Address - Phone:843-784-3000
Practice Address - Fax:843-784-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X, 101YS0200X, 103T00000X, 1041C0700X, 1041S0200X, 106H00000X
SC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty