Healthcare Provider Details

I. General information

NPI: 1346051968
Provider Name (Legal Business Name): CAISEY HUTTO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 PICKENS ST
COLUMBIA SC
29201-2630
US

IV. Provider business mailing address

1817 PICKENS ST
COLUMBIA SC
29201-2630
US

V. Phone/Fax

Practice location:
  • Phone: 803-563-8716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10513
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: