Provider Demographics
NPI:1629436480
Name:LEE-CARTER, REGINA
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:LEE-CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 OXFORD ST STE C-6
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-3300
Mailing Address - Country:US
Mailing Address - Phone:803-607-8058
Mailing Address - Fax:803-879-4605
Practice Address - Street 1:402 HAYNSWORTH ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4008
Practice Address - Country:US
Practice Address - Phone:803-607-8058
Practice Address - Fax:803-879-4605
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10678101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)