Individual
MRS. PATRICIA L COSTILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1140 BOONE HILL RD STE A, SUMMERVILLE, SC 29483-2402
(843) 695-9997
(854) 300-4965
Mailing address
275 CHEYENNE RD, SUMMERVILLE, SC 29483-8301
(803) 743-6128
(854) 300-4965
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6630
SC
101YM0800X
Mental Health Counselor
Primary
7168
SC
Other
Enumeration date
11/30/2018
Last updated
09/02/2025
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