Individual
MARIEL BROOKE BEROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, CACP
Contact information
Practice address
1068 S LAKE DR, LEXINGTON, SC 29073-3720
(803) 726-9362
Mailing address
1068 S LAKE DR, LEXINGTON, SC 29073-3720
(803) 726-9362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
10798
SC
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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