Healthcare Provider Details

I. General information

NPI: 1922990621
Provider Name (Legal Business Name): COUNSELING AND FAMILY ENRICHMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4408 FOREST DR STE 102
COLUMBIA SC
29206-3162
US

IV. Provider business mailing address

4408 FOREST DR STE 102
COLUMBIA SC
29206-3162
US

V. Phone/Fax

Practice location:
  • Phone: 949-282-9667
  • Fax:
Mailing address:
  • Phone: 949-282-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEIDRA RILEY
Title or Position: PARTNER/THERAPIST
Credential: LPC-A
Phone: 949-282-9667