Healthcare Provider Details

I. General information

NPI: 1831901024
Provider Name (Legal Business Name): ASPIRE CLINICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 LEESBURG RD STE C
COLUMBIA SC
29209-2255
US

IV. Provider business mailing address

1314 LEESBURG RD STE C
COLUMBIA SC
29209-2255
US

V. Phone/Fax

Practice location:
  • Phone: 803-445-8960
  • Fax:
Mailing address:
  • Phone: 803-445-8960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. LATOYA EDWARDS
Title or Position: FOUNDER/ CEO
Credential: LPC
Phone: 803-445-8960