Basic Information
| Provider Information | |||||||||
| NPI: | 1326115031 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROLINA PSYCHIATRIC SERVICES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 MEDICAL CIR | ||||||||
| Address2: | FIRST FLOOR | ||||||||
| City: | WEST COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291693656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037966811 | ||||||||
| FaxNumber: | 8037966851 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 MEDICAL CIR | ||||||||
| Address2: | FIRST FLOOR | ||||||||
| City: | WEST COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291693656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037966811 | ||||||||
| FaxNumber: | 8037966851 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2006 | ||||||||
| LastUpdateDate: | 10/30/2013 | ||||||||
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| AuthorizedOfficialLastName: | HUNT | ||||||||
| AuthorizedOfficialFirstName: | CYNTHIA | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8037966811 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 815 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | 1041C0700X | 4924 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 163WP0808X | 46841 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 163WP0808X | 89467 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 2084P0800X | 11630 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 13334 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 10370 | SC | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 7166 | SC | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.