Provider Demographics
NPI:1457496085
Name:STOREN, LOUISA (LISW,LMFT)
Entity Type:Individual
Prefix:MS
First Name:LOUISA
Middle Name:
Last Name:STOREN
Suffix:
Gender:F
Credentials:LISW,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 JOHNNIE DODDS BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3190
Mailing Address - Country:US
Mailing Address - Phone:843-416-1103
Mailing Address - Fax:843-416-1153
Practice Address - Street 1:886 JOHNNIE DODDS BLVD
Practice Address - Street 2:STE 201
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3190
Practice Address - Country:US
Practice Address - Phone:843-416-1103
Practice Address - Fax:843-416-1153
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC861041C0700X
SC1390106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist