Provider Demographics
NPI:1902997844
Name:GARNER, CHARLENE D
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:D
Last Name:GARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 FABER PLACE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-8585
Mailing Address - Country:US
Mailing Address - Phone:843-501-1099
Mailing Address - Fax:843-405-2040
Practice Address - Street 1:4000 FABER PLACE DR STE 110
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8585
Practice Address - Country:US
Practice Address - Phone:843-501-1099
Practice Address - Fax:843-405-2040
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SC9483101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health