Provider Demographics
NPI:1861869059
Name:CARN, LOUIS (LISW-CP)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:CARN
Suffix:
Gender:M
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 GERVAIS ST STE 104
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3415
Mailing Address - Country:US
Mailing Address - Phone:803-560-8208
Mailing Address - Fax:803-560-8210
Practice Address - Street 1:1717 GERVAIS ST STE 104
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3415
Practice Address - Country:US
Practice Address - Phone:803-560-8208
Practice Address - Fax:803-560-8210
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10392101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health