Healthcare Provider Details

I. General information

NPI: 1154734564
Provider Name (Legal Business Name): ANSLEY GASQUE-CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 PICKENS ST
COLUMBIA SC
29201-2630
US

IV. Provider business mailing address

120 GALES RIVER RD
IRMO SC
29063-2457
US

V. Phone/Fax

Practice location:
  • Phone: 803-381-0580
  • Fax:
Mailing address:
  • Phone: 803-381-0580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number360
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10825
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: