Lowcountry Bridges, LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

BL005424-12-2016 Issued in SC

Legal business name

LOWCOUNTRY BRIDGES, LLC

Practice address

2225 Ashley Crossing Dr
Suite 102
Charleston, SC 29414-5852

Phone

(843) 779-0167

Fax

(844) 864-1700

NPI assigned

Jan 13, 2017

Last updated

Jan 13, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Catherine M Carbone, LPC/I, BCBA

Title

Clinic Director

Phone

(843) 718-9922

Specialties & licenses 1

Addresses

Other names 1

• Lowcountry Bridges Behavioral Support Services, LL Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1053857102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 ASHLEY CROSSING DR",
            "address_2": "SUITE 102",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145852",
            "telephone_number": "843-779-0167",
            "fax_number": "844-864-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 ASHLEY CROSSING DR",
            "address_2": "SUITE 102",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145852",
            "telephone_number": "843-779-0167",
            "fax_number": "844-864-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY BRIDGES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-13",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "CARBONE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "843-718-9922",
        "authorized_official_credential": "LPC/I, BCBA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "SC",
            "license": "BL005424-12-2016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lowcountry Bridges Behavioral Support Services, LL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Early Intervention Provider Agency in Charleston, SC
• Providers in Charleston, SC by specialty
• Early Intervention Provider Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.