Provider Demographics
NPI:1275299976
Name:AYRES, CAROLINE SANTORUM (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:SANTORUM
Last Name:AYRES
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 1:1714 S LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-7215
Mailing Address - Country:US
Mailing Address - Phone:843-879-4121
Mailing Address - Fax:
Practice Address - Street 1:1714 S LIVE OAK DR
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-7215
Practice Address - Country:US
Practice Address - Phone:843-879-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC.8019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health