Healthcare Provider Details

I. General information

NPI: 1285648105
Provider Name (Legal Business Name): HARBISON PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARBISON WAY SUITE 229
COLUMBIA SC
29212-3422
US

IV. Provider business mailing address

1 HARBISON WAY SUITE 229
COLUMBIA SC
29212-3422
US

V. Phone/Fax

Practice location:
  • Phone: 809-749-6620
  • Fax: 803-407-6905
Mailing address:
  • Phone: 809-749-6620
  • Fax: 803-407-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberSC809
License Number StateSC

VIII. Authorized Official

Name: DR. STEPHANIE B BOYD
Title or Position: PRESIDENT AND OWNER
Credential: PHD
Phone: 803-749-6620