Provider Demographics
NPI:1720770431
Name:CHARLESTON CONFIDENT CO LLC
Entity Type:Organization
Organization Name:CHARLESTON CONFIDENT CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIERA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:CD(DONA), CLC, BS
Authorized Official - Phone:843-640-5379
Mailing Address - Street 1:1318 N MAIN ST # 1492
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-7308
Mailing Address - Country:US
Mailing Address - Phone:843-640-5379
Mailing Address - Fax:
Practice Address - Street 1:1609 BEECH HILL RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-7870
Practice Address - Country:US
Practice Address - Phone:843-640-5379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty