Organization
LAKE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN DOWNS LAKE PH.D. (OWNER)
(803) 699-8887
Entity
Organization
Contact information
Practice address
115 ATRIUM WAY, SUITE #221, COLUMBIA, SC 29223-6383
(803) 699-8887
(803) 699-8824
Mailing address
115 ATRIUM WAY, SUITE #221, COLUMBIA, SC 29223-6383
(803) 699-8887
(803) 699-8824
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
690
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0264
—
SC
Enumeration date
07/08/2006
Last updated
01/17/2014
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