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Organization

LOWCOUNTRY PSYCHOTHERAPY ASSOCIATES, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS FOUNTAIN CRANE M.D. (PRESIDENT)
(843) 795-3585
Entity
Organization

Contact information

Practice address
105 WAPPOO CREEK DR, SUITE 2A, CHARLESTON, SC 29412-2134
(843) 795-3585
(843) 795-9728
Mailing address
105 WAPPOO CREEK DR, SUITE 2A, CHARLESTON, SC 29412-2167
(843) 795-3585
(843) 795-9728

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
7808
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
078089
SC
Enumeration date
08/22/2007
Last updated
08/22/2007
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