Healthcare Provider Details

I. General information

NPI: 1023493194
Provider Name (Legal Business Name): TAWANA N HAYES-NEWTON M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 FOREST DR STE 302
COLUMBIA SC
29204-4057
US

IV. Provider business mailing address

3600 FOREST DR STE 302
COLUMBIA SC
29204-4057
US

V. Phone/Fax

Practice location:
  • Phone: 803-699-8887
  • Fax: 803-699-8824
Mailing address:
  • Phone: 803-699-8887
  • Fax: 803-699-8824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8266
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: