Healthcare Provider Details

I. General information

NPI: 1902205131
Provider Name (Legal Business Name): JOSEPH RUFUS WOFFORD MA, LPC, NCC, CCMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8063 EDMUND HWY
PELION SC
29123-9805
US

IV. Provider business mailing address

PO BOX 3788
COLUMBIA SC
29230-3788
US

V. Phone/Fax

Practice location:
  • Phone: 803-894-3736
  • Fax: 803-894-5315
Mailing address:
  • Phone: 803-733-5969
  • Fax: 803-753-5591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number007517
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5462
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: