Individual
DR. CHARLENE ANNETTE MOORE-PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D, LPC
Contact information
Practice address
6454 BRIDGEWOOD RD, COLUMBIA, SC 29206-2126
(803) 500-5065
Mailing address
6454 BRIDGEWOOD RD, COLUMBIA, SC 29206-2126
(803) 500-5065
(803) 500-5065
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6666
SC
101YM0800X
Mental Health Counselor
LPC011406
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421504
—
SC
Enumeration date
09/17/2007
Last updated
08/15/2023
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