Individual
SHANTA PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1156 BOWMAN RD, MOUNT PLEASANT, SC 29464-3803
(843) 352-9749
Mailing address
1156 BOWMAN RD, MOUNT PLEASANT, SC 29464-3803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7440
SC
101YP2500X
Professional Counselor
7440
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7440
LICENSED PROFESSIONAL COUNSELOR
SC
Enumeration date
04/09/2020
Last updated
04/09/2020
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