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NPI Code Detail

MEDICARE: BARBARA VAN CLEAVE SHERIDAN LPC

MEDICARE: BARBARA VAN CLEAVE SHERIDAN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor5258SC

General Provider Information

NPI Number : 1134355878
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA VAN CLEAVE SHERIDAN LPC
Provider Business Mailing Address
First Line : 2611 RIVER DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-1749
Country : US
Telephone Number : 803-622-9534
Fax Number :
Provider Business Practice Location Address
First Line : 2611 RIVER DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-1749
Country : US
Telephone Number : 803-622-9534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2009
Last Update Date : 04/04/2011

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Directions to “ BARBARA VAN CLEAVE SHERIDAN LPC” Practice Location

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