Provider Demographics
NPI:1023736964
Name:D'EUGENIO, LARA (LPC)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:
Last Name:D'EUGENIO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 SALTERBECK ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7165
Mailing Address - Country:US
Mailing Address - Phone:843-817-1585
Mailing Address - Fax:
Practice Address - Street 1:3301 SALTERBECK ST STE 101
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7165
Practice Address - Country:US
Practice Address - Phone:843-817-1585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8243101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional