Individual
NANCY JOHNSON WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
67 PRESIDENT ST, INSTITUTE OF PSYCHIATRY, 5 SOUTH, CHARLESTON, SC 29425-5712
(843) 792-0195
(843) 792-4190
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1190
SC
103TC0700X
Clinical Psychologist
23751
TX
103TH0100X
Health Service Psychologist
23751
TX
103TP0814X
Psychoanalysis Psychologist
23751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000T566
—
TX
Enumeration date
08/29/2006
Last updated
10/22/2020
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