Provider Demographics
NPI:1700132123
Name:MARY P PRICE LLC
Entity Type:Organization
Organization Name:MARY P PRICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-224-3966
Mailing Address - Street 1:222 W COLEMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3588
Mailing Address - Country:US
Mailing Address - Phone:843-224-3966
Mailing Address - Fax:843-881-0358
Practice Address - Street 1:222 W COLEMAN BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3588
Practice Address - Country:US
Practice Address - Phone:843-224-3966
Practice Address - Fax:843-881-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty