Healthcare Provider Details

I. General information

NPI: 1265491377
Provider Name (Legal Business Name): REACH FAMILY COUNSELING SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 WILSON BLVD
COLUMBIA SC
29203-3017
US

IV. Provider business mailing address

PO BOX 658
IRMO SC
29063-0658
US

V. Phone/Fax

Practice location:
  • Phone: 803-333-9923
  • Fax: 803-333-9926
Mailing address:
  • Phone: 803-333-9923
  • Fax: 803-333-9926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2344
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2517
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2344
License Number StateSC

VIII. Authorized Official

Name: DR. SAMUEL NJUGUNA NAGI
Title or Position: DIRECTOR OF SOCIAL SERVICES
Credential: LPCS, ED.S, D.MIN
Phone: 803-333-9923