Healthcare Provider Details

I. General information

NPI: 1790926327
Provider Name (Legal Business Name): HOPE MELINDA GARVIN MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 STERLING CROSS CT
COLUMBIA SC
29229-7732
US

IV. Provider business mailing address

93 STERLING CROSS CT
COLUMBIA SC
29229-7732
US

V. Phone/Fax

Practice location:
  • Phone: 803-419-7961
  • Fax:
Mailing address:
  • Phone: 803-419-7961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5359
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: