OrganizationActive
Colonial Family Practice, LLC
NPI 1336810175 · Child & Adolescent Psychiatry Physician · Sumter, SC
Provider details
- NPI number
- 1336810175
- Entity type
- Organization
- Primary specialty
- Child & Adolescent Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Colonial Family Practice, LLC
- Organization subpart
- Yes
- Authorized official
- Stephanie Disher, Credentialing Manager(803) 773-5227
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Counselor101Y00000X
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
Practice location
696 Bultman Dr.
Sumter, SC 29150-2549
Phone: (803) 773-5227
Approximate (ZIP-level) locationGet directions
Mailing address
674 W Liberty St
Sumter, SC 29150-4882
Other names (DBA / former)
- Doing business as
- Colonial Behavioral Health
Registry dates
- Enumerated
- 2021-09-22
- Last updated
- 2021-09-22
- Certified
- 2021-09-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.