Healthcare Provider Details

I. General information

NPI: 1851201602
Provider Name (Legal Business Name): HEATHER COLEMAN THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3971 SOUTHEASTERN WAY
WEST COLUMBIA SC
29169-2442
US

IV. Provider business mailing address

3971 SOUTHEASTERN WAY
WEST COLUMBIA SC
29169-2442
US

V. Phone/Fax

Practice location:
  • Phone: 803-306-5058
  • Fax: 803-887-6001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HEATHER COLEMAN
Title or Position: OWNER
Credential: LISW-CP
Phone: 843-608-0006