Provider Demographics
NPI:1366793283
Name:MOSSPINKNEY, DEIDRE (LPC)
Entity type:Individual
Prefix:DR
First Name:DEIDRE
Middle Name:
Last Name:MOSSPINKNEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:DR
Other - First Name:DEIDRE
Other - Middle Name:
Other - Last Name:PINKNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2810 ASHLEY PHOSPHATE RD STE B8
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-6406
Mailing Address - Country:US
Mailing Address - Phone:843-276-6510
Mailing Address - Fax:843-277-2473
Practice Address - Street 1:2810 ASHLEY PHOSPHATE RD STE B8
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-6406
Practice Address - Country:US
Practice Address - Phone:843-276-6510
Practice Address - Fax:843-277-2473
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1012235101YA0400X
GALPC009676101YP2500X
SC5422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional