Healthcare Provider Details

I. General information

NPI: 1912666785
Provider Name (Legal Business Name): TRENT PEELER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 BUSINESS PARK BLVD
COLUMBIA SC
29203-9659
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 803-744-0841
  • Fax:
Mailing address:
  • Phone: 843-501-1099
  • Fax: 843-405-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11059
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8103
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: