Healthcare Provider Details

I. General information

NPI: 1144143512
Provider Name (Legal Business Name): FORESEEABLE FUTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 TWO NOTCH RD STE 5
COLUMBIA SC
29223-1612
US

IV. Provider business mailing address

9600 TWO NOTCH RD STE 5
COLUMBIA SC
29223-1612
US

V. Phone/Fax

Practice location:
  • Phone: 470-522-1101
  • Fax: 470-209-6135
Mailing address:
  • Phone: 470-522-1101
  • Fax: 470-209-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHANTAY EVANS
Title or Position: CEO
Credential:
Phone: 470-522-1101