Healthcare Provider Details

I. General information

NPI: 1245444751
Provider Name (Legal Business Name): AARON L ASHFORD I LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 AUTUMN GLEN RD
COLUMBIA SC
29229-7643
US

IV. Provider business mailing address

1825 SAINT JULIAN PL
COLUMBIA SC
29204-2424
US

V. Phone/Fax

Practice location:
  • Phone: 803-462-0814
  • Fax:
Mailing address:
  • Phone: 803-254-1210
  • Fax: 803-254-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4733
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: