Provider Demographics
NPI:1851862031
Name:LAGANCHAMBERS, IRENE MARIE (MS, LPCA)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:MARIE
Last Name:LAGANCHAMBERS
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-7925
Mailing Address - Country:US
Mailing Address - Phone:202-286-8157
Mailing Address - Fax:
Practice Address - Street 1:720 MAGNOLIA RD STE 2
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7094
Practice Address - Country:US
Practice Address - Phone:843-779-9563
Practice Address - Fax:202-286-8157
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional