Provider Demographics
NPI:1245250364
Name:ADAMS, CHARLES (PHD, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 COLLEGE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3917
Mailing Address - Country:US
Mailing Address - Phone:803-777-2630
Mailing Address - Fax:803-777-3081
Practice Address - Street 1:1705 COLLEGE ST STE 220
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3917
Practice Address - Country:US
Practice Address - Phone:803-777-2605
Practice Address - Fax:803-777-3081
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist