Individual
SUSAN KAYE CRISP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4303 LIVE OAK DR, LITTLE RIVER, SC 29566-9138
(843) 663-8000
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-8000
(843) 663-8166
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
0701008164
VA
101YP2500X
Professional Counselor
Primary
7799
SC
171W00000X
Contractor
—
—
225800000X
Recreation Therapist
43287
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC2522
—
SC
Enumeration date
08/24/2011
Last updated
01/07/2022
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