MEDICARE: COUNSELING AND FAMILY ENRICHMENT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	101YP1600X	Pastoral Counselor
5	101YP2500X	Professional Counselor
6	101Y00000X	Counselor

General Provider Information

NPI Number	:	1922990621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING AND FAMILY ENRICHMENT LLC

Provider Business Mailing Address
First Line	:	4408 FOREST DR STE 102
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-3162
Country	:	US
Telephone Number	:	949-282-9667
Fax Number	:

Provider Business Practice Location Address
First Line	:	4408 FOREST DR STE 102
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-3162
Country	:	US
Telephone Number	:	949-282-9667
Fax Number	:

Authorized Official
Title or Position	:	PARTNER/THERAPIST
Name	:	MRS. DEIDRA RILEY
Credential	:	LPC-A
Telephone Number	:	949-282-9667

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	10/04/2025

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