Provider Demographics
NPI:1407279870
Name:COGNITIVE & BEHAVIORAL HEALTH CENTER OF CHARLESTON, LLC
Entity Type:Organization
Organization Name:COGNITIVE & BEHAVIORAL HEALTH CENTER OF CHARLESTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONNIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:843-501-7001
Mailing Address - Street 1:PO BOX 31106
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29417-1106
Mailing Address - Country:US
Mailing Address - Phone:843-501-7001
Mailing Address - Fax:843-501-7542
Practice Address - Street 1:29 LEINBACH DR
Practice Address - Street 2:SUITE D2
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7071
Practice Address - Country:US
Practice Address - Phone:843-501-7001
Practice Address - Fax:843-501-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty