Healthcare Provider Details

I. General information

NPI: 1013854306
Provider Name (Legal Business Name): THRIVING MINDS PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 ASHCROFT CIR
COLUMBIA SC
29229-8023
US

IV. Provider business mailing address

10120 TWO NOTCH RD STE 2-349
COLUMBIA SC
29223-4395
US

V. Phone/Fax

Practice location:
  • Phone: 803-602-4904
  • Fax:
Mailing address:
  • Phone: 803-602-4904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. NIKKI RACQUEL SMITH
Title or Position: NURSE PRACTITIONER
Credential: DNP, APRN, FNP-BC
Phone: 803-602-4904