Healthcare Provider Details

I. General information

NPI: 1538440607
Provider Name (Legal Business Name): TRANSITIONS COUNSELING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 RUTLEDGE ST
COLUMBIA SC
29204-2520
US

IV. Provider business mailing address

2625 RUTLEDGE ST
COLUMBIA SC
29204-2520
US

V. Phone/Fax

Practice location:
  • Phone: 803-748-0200
  • Fax:
Mailing address:
  • Phone: 803-748-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4594
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9213
License Number StateSC

VIII. Authorized Official

Name: MS. LINDA D WHEATLEY
Title or Position: PARTNER
Credential: MSW
Phone: 850-567-7627