Provider Demographics
NPI:1689136244
Name:PINCKNEY, DENISE WILKEY
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:WILKEY
Last Name:PINCKNEY
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 1:102 GINN ALTMAN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:SC
Mailing Address - Zip Code:29924-3963
Mailing Address - Country:US
Mailing Address - Phone:803-943-2800
Mailing Address - Fax:803-943-2267
Practice Address - Street 1:102 GINN ALTMAN AVE STE C
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924-3963
Practice Address - Country:US
Practice Address - Phone:803-943-2800
Practice Address - Fax:803-943-2267
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOTP-0078101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)