| Centerway Behavioral Health Llc | |
|
2079 Charlie Hall Blvd Charleston SC 29414-5834 | |
| (843) 974-5622 | |
| Not Available |
| Full Name | Centerway Behavioral Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2079 Charlie Hall Blvd, Charleston, South Carolina |
| Authorized Official Name and Position | Erik Cantrell (FOUNDER / CEO) |
| Authorized Official Contact | 9797771459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerway Behavioral Health Llc 2079 Charlie Hall Blvd Charleston SC 29414-5834 Ph: (843) 974-5622 | Centerway Behavioral Health Llc 2079 Charlie Hall Blvd Charleston SC 29414-5834 Ph: (843) 974-5622 |
| NPI Number | 1023534302 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 4981943818 |
|---|---|
| Medicare Enrollment ID | O20190311002158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023534302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Erik D Cantrell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750519948 PECOS PAC ID: 1557660487 Enrollment ID: I20160428000069 |
| Provider Name | Lyn I Lipat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841700259 PECOS PAC ID: 5597022087 Enrollment ID: I20171208002381 |
| Provider Name | Carla Ann Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912555988 PECOS PAC ID: 7911238548 Enrollment ID: I20191014001805 |
| Provider Name | Michael Casey Kundert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326620436 PECOS PAC ID: 6002215795 Enrollment ID: I20210601000142 |
| Provider Name | Creinthea Joyce Chritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558008854 PECOS PAC ID: 7012398100 Enrollment ID: I20220720003500 |
| Provider Name | Sean Donald Eberhard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063121044 PECOS PAC ID: 1557724788 Enrollment ID: I20230905003639 |
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