Healthcare Provider Details

I. General information

NPI: 1831852599
Provider Name (Legal Business Name): SHAQUANDRIA QUINTINETTE HARRIS LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGTREE DR STE 200
COLUMBIA SC
29223-8614
US

IV. Provider business mailing address

PO BOX 181
RICHBURG SC
29729-0181
US

V. Phone/Fax

Practice location:
  • Phone: 803-722-4975
  • Fax:
Mailing address:
  • Phone: 803-374-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8698
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: