Healthcare Provider Details

I. General information

NPI: 1457278285
Provider Name (Legal Business Name): CAMGREEN PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MAIN ST STE 300
COLUMBIA SC
29201-3266
US

IV. Provider business mailing address

1320 MAIN ST STE 300
COLUMBIA SC
29201-3266
US

V. Phone/Fax

Practice location:
  • Phone: 803-590-0237
  • Fax: 803-266-6467
Mailing address:
  • Phone: 803-590-0237
  • Fax: 803-266-6467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NIKKI R SMITH
Title or Position: OWNER & FOUNDER
Credential: PMHNP-BC, FNP-BC
Phone: 803-590-0237