Individual
STACY LYNN COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LISW-CP
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
3571 FRANKLIN TOWER DR, MT PLEASANT, SC 29466-9383
(502) 550-9296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9845
SC
Other
Enumeration date
08/31/2006
Last updated
01/30/2018
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