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Organization

SUPPORTIVE CARE OF SOUTH CAROLINA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAPHAEL LICHTSCHEIN (PRESIDENT)
(718) 298-4375
Entity
Organization

Contact information

Practice address
734 YORK ST, MT PLEASANT, SC 29464-2615
(718) 298-4375
Mailing address
27 RANDOLPH RD, HOWELL, NJ 07731-8611
(718) 298-4375

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1041C0700X
Clinical Social Worker
363L00000X
Nurse Practitioner

Other

Enumeration date
07/14/2022
Last updated
07/14/2022
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