Provider Demographics
NPI:1649733700
Name:LOWCOUNTRY THERAPY OF SC LLC
Entity type:Organization
Organization Name:LOWCOUNTRY THERAPY OF SC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KIERPIEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-557-2667
Mailing Address - Street 1:119 KING CHARLES CIR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-3408
Mailing Address - Country:US
Mailing Address - Phone:843-822-5837
Mailing Address - Fax:855-435-6230
Practice Address - Street 1:208 W 7TH NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6621
Practice Address - Country:US
Practice Address - Phone:843-557-2667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-07
Last Update Date:2019-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty