Healthcare Provider Details

I. General information

NPI: 1619256047
Provider Name (Legal Business Name): VILLAGE CONCEPTS CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 LAKE CAROLINA BLVD
COLUMBIA SC
29229-7549
US

IV. Provider business mailing address

PO BOX 291003
COLUMBIA SC
29229-0017
US

V. Phone/Fax

Practice location:
  • Phone: 803-417-8239
  • Fax: 803-834-7031
Mailing address:
  • Phone: 803-417-8239
  • Fax: 803-834-7031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number106498
License Number StateSC

VIII. Authorized Official

Name: MRS. REGENIA M RAWLINSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 803-417-8239