Provider Demographics
NPI:1548065915
Name:CHAMBERS, LUTRICIA LOURINE (PMHNP)
Entity type:Individual
Prefix:
First Name:LUTRICIA
Middle Name:LOURINE
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E CRICKLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-5106
Mailing Address - Country:US
Mailing Address - Phone:843-206-9022
Mailing Address - Fax:
Practice Address - Street 1:105 FRANKLIN SQUARE WAY STE A
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-3715
Practice Address - Country:US
Practice Address - Phone:864-442-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29828A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health