Doctor Name: | MR. WILLIAM PHELPS BRICKLE |
NPI Number: | 1437342243 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P.C. |
License Number: | SC-1053 |
Business Practice Address: | 5803 Lakeview Dr Hanahan, SC - 294102422 |
Business Phone Number: | 8437444368 |
Business Fax Number: | 8437440196 |
Mailing Address: | 5803 Lakeview Dr, HANAHAN |
State: | SC |
Postal Code: | 294102422 |
Phone Number: | 8437444368 |
Fax Number: | 8437440196 |
NPI Enumeration Date: | 08/24/2007 |
NPI Last Update Date: | 09/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | SC-1053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |