| Lake Psychological Services, Llc | |
|
115 Atrium Way Suite #221 Columbia SC 29223-6383 | |
| (803) 699-8887 | |
| (803) 699-8824 |
| Full Name | Lake Psychological Services, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 115 Atrium Way, Columbia, South Carolina |
| Authorized Official Name and Position | Karen Downs Lake (OWNER) |
| Authorized Official Contact | 8036998887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Psychological Services, Llc 115 Atrium Way Suite #221 Columbia SC 29223-6383 Ph: (803) 699-8887 | Lake Psychological Services, Llc 115 Atrium Way Suite #221 Columbia SC 29223-6383 Ph: (803) 699-8887 |
| NPI Number | 1225061971 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 01/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225061971 | NPI | - | NPPES |
| PS0264 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 690 (South Carolina) | Primary |
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