1629366646 NPI number — CAROL PEYTON WEBER M.S., LPC, LAC, NCC

Table of content: CAROL PEYTON WEBER M.S., LPC, LAC, NCC (NPI 1629366646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629366646 NPI number — CAROL PEYTON WEBER M.S., LPC, LAC, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEBER
Provider First Name:
CAROL
Provider Middle Name:
PEYTON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., LPC, LAC, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629366646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
137 OLD SAYBROOK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29418-2025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-693-6825
Provider Business Mailing Address Fax Number:
800-567-4086

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4900 O'HEAR AVENUE
Provider Second Line Business Practice Location Address:
SUITE 100 PMB #315
Provider Business Practice Location Address City Name:
NORTH CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-284-3444
Provider Business Practice Location Address Fax Number:
800-567-4086
Provider Enumeration Date:
07/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  5032 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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