Individual
ERNEST FREDRICK MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC-I
Contact information
Practice address
1011 EAST AVE, NORTH AUGUSTA, SC 29841-3411
(803) 474-5129
Mailing address
1011 EAST AVE, NORTH AUGUSTA, SC 29841-3411
(803) 474-5129
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7053
—
SC
Enumeration date
01/19/2016
Last updated
01/19/2016
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