Healthcare Provider Details

I. General information

NPI: 1700930641
Provider Name (Legal Business Name): EVE PRICE POWELL LSPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 MARION ST ACS
COLUMBIA SC
29201-2113
US

IV. Provider business mailing address

119 SMITHS MARKET CT
COLUMBIA SC
29212-1923
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-0127
  • Fax: 803-898-0166
Mailing address:
  • Phone: 803-732-1567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: