Provider Demographics
NPI:1457974511
Name:WOODS, ROBERT B JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:B
Last Name:WOODS
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 COOPERS BASIN CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-8029
Mailing Address - Country:US
Mailing Address - Phone:843-697-7069
Mailing Address - Fax:
Practice Address - Street 1:3009 COOPERS BASIN CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-8029
Practice Address - Country:US
Practice Address - Phone:843-697-7069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-24
Last Update Date:2020-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional