Basic Information
| Provider Information | |||||||||
| NPI: | 1245741156 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAWSON | ||||||||
| FirstName: | MARLA | ||||||||
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| Mailing Information | |||||||||
| Address1: | COASTAL EMPIRE MENTAL HEALTH CENTER | ||||||||
| Address2: | 1050 RIBAUNT ROAD | ||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8425243378 | ||||||||
| FaxNumber: | 8435241879 | ||||||||
| Practice Location | |||||||||
| Address1: | 1050 RIBAUT RD | ||||||||
| Address2: | |||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299025400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435243378 | ||||||||
| FaxNumber: | 8435241879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2017 | ||||||||
| LastUpdateDate: | 10/18/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | GA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.