Organization
LAKESIDE FAMILY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LOUISE VINSON MA, LPC (OWNER)
(843) 761-3325
Entity
Organization
Contact information
Practice address
219 N HIGHWAY 52, STE R, MONCKS CORNER, SC 29461-3926
(843) 761-3325
Mailing address
219 N HIGHWAY 52, STE R, MONCKS CORNER, SC 29461-3926
(843) 761-3325
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4776
SC
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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