Provider Demographics
NPI:1710199732
Name:POOSER, FREDERICK G (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:G
Last Name:POOSER
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 SECESSIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9751
Mailing Address - Country:US
Mailing Address - Phone:843-556-3939
Mailing Address - Fax:843-135-2658
Practice Address - Street 1:1065 SECESSIONVILLE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9751
Practice Address - Country:US
Practice Address - Phone:843-556-3939
Practice Address - Fax:843-135-2658
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health