Basic Information
| Provider Information | |||||||||
| NPI: | 1619256922 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | MCQUEEN | ||||||||
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| Credential: | LPC, CAC-II | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1050 RIBAUT RD | ||||||||
| Address2: | COATAL EMPIRE COMMUNITY MENTAL HEALTH | ||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299028732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8036823521 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1050 RIBAUT RD | ||||||||
| Address2: | COASTAL EMPIRE MENTAL HEALTH | ||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435248899 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2011 | ||||||||
| LastUpdateDate: | 02/07/2014 | ||||||||
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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 | 101YA0400X | 1302251 | SC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 5530 | SC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.