Organization
CAROLINA YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD WITHERSPOON M.A. (DIRECTOR)
(843) 452-0268
Entity
Organization
Contact information
Practice address
2150 SPOLATO LN E, CHARLESTON, SC 29406
(843) 452-0268
Mailing address
101 TEA OLIVE CT, SUMMERVILLE, SC 29485
(843) 452-0268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LIC-5-11-62510
SC
Other
Enumeration date
09/14/2011
Last updated
09/19/2011
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