Individual
BRIAN L MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CACII, NCACI
Contact information
Practice address
23 DANIEL MORRALL LN, GEORGETOWN, SC 29440-6888
(843) 344-2975
Mailing address
23 DANIEL MORRALL LN, GEORGETOWN, SC 29440-6888
(843) 344-2975
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
013885
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1301178
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013885
NCACI
SC
01
—
1301178
CACII
SC
Enumeration date
01/28/2013
Last updated
01/28/2013
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