Provider Demographics
NPI:1669719050
Name:NESTER, CONSTANCE LEE (MA, EDS, LPES)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:LEE
Last Name:NESTER
Suffix:
Gender:
Credentials:MA, EDS, LPES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-1722
Mailing Address - Country:US
Mailing Address - Phone:803-860-0466
Mailing Address - Fax:
Practice Address - Street 1:164 2ND ST
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003-1722
Practice Address - Country:US
Practice Address - Phone:803-860-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2025-03-19
Deactivation Date:2013-02-20
Deactivation Code:
Reactivation Date:2025-03-18
Provider Licenses
StateLicense IDTaxonomies
SC4668103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool