Organization · Type 2 NPI

Colonial Family Practice, LLC

Child & Adolescent Psychiatry Physician · Sumter, SC

NPI number 1336810175 Active

Practice location

696 Bultman Dr.
Sumter, SC 29150-2549

Call (803) 773-5227 Map

Mailing address

674 W Liberty St
Sumter, SC 29150-4882

Specialties and licenses

Taxonomy	Code	License
Counselor	101Y00000X	None listed
Addiction (Substance Use Disorder) Counselor	101YA0400X	None listed
Mental Health Counselor	101YM0800X	None listed
Professional Counselor	101YP2500X	None listed
Child & Adolescent Psychiatry Physician Primary	2084P0804X	None listed

Child & Adolescent Psychiatry Physician: Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Another provider at this address

Meghan K. Wachter, PMHNPPsychiatric/Mental Health Nurse Practitioner Sumter, SC NPI 1063173383

NPI record

NPI: 1336810175
Entity type: Organization (Type 2)
Issued: Sep 22, 2021
Last updated: Sep 22, 2021
Status: Active
Subpart: Yes of Colonial Family Practice, LLC

Other names

Colonial Behavioral Health · doing business as

Authorized official

Stephanie Knight Disher
Credentialing Manager
(803) 773-5227

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1336810175

Colonial Family Practice, LLC's National Provider Identifier is 1336810175, issued on Sep 22, 2021. The primary taxonomy on file is Child & Adolescent Psychiatry Physician (2084P0804X), and the practice location is in Sumter, SC. The record was last updated on Sep 22, 2021.