Organization
WACCAMAWS HEALTH AND WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. LAKEYSA MARIE JOHNSON CAC-P, MSW, LISW-CP (CEO/PSYCHOTHERAPIST)
(843) 279-0172
Entity
Organization
Contact information
Practice address
314A LAUREL ST, SUITE 205, CONWAY, SC 29526-5157
(843) 279-0172
(843) 438-5386
Mailing address
314A LAUREL ST, SUITE 205, CONWAY, SC 29526-5157
(843) 279-0172
(843) 438-5386
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7334
SC
Other
Enumeration date
10/24/2012
Last updated
06/18/2013
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