Provider Demographics
NPI:1659013530
Name:CARLISLE, TERESA (LPC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:CARLISLE
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 1:35 PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-9775
Mailing Address - Country:US
Mailing Address - Phone:864-569-4350
Mailing Address - Fax:
Practice Address - Street 1:35 PINECREST RD
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-9775
Practice Address - Country:US
Practice Address - Phone:864-569-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional