Organization
CHARLESTON COUNSELING CENTER PC
Active
Other names
Lifestance Health
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PARDO (CHIEF LEGAL OFFICER)
(425) 279-8500
Entity
Organization
Contact information
Practice address
871 LOWCOUNTRY BLVD STE 200, MOUNT PLEASANT, SC 29464
(843) 501-1099
Mailing address
871 LOWCOUNTRY BLVD STE 200, MOUNT PLEASANT, SC 29464-3096
(843) 501-1099
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
8539
SC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/24/2013
Last updated
10/05/2023
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