Provider Demographics
NPI:1407169022
Name:TOMEO, CAROL S (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:S
Last Name:TOMEO
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 1:10 PINCKNEY COLONY RD
Mailing Address - Street 2:BLDG #300 SUITE # 301
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-4126
Mailing Address - Country:US
Mailing Address - Phone:843-815-8588
Mailing Address - Fax:843-815-8573
Practice Address - Street 1:10 PINCKNEY COLONY RD
Practice Address - Street 2:BLDG #300 SUITE # 301
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-4126
Practice Address - Country:US
Practice Address - Phone:843-815-8588
Practice Address - Fax:843-815-8573
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-24
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1043Medicaid