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General NPI Number Information
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NPI Number | 1013719327
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Entity Type | Organization
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Legal Business Name | MR THERAPY
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 3800 FOREST DR STE A205
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City | COLUMBIA
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State | SC
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Zip | 29204-4146
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Country | US
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Telephone | 803-542-9603
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Fax |
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Provider Business Mailing Address
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Address Line | 246 COLUMBIA CLUB DR E
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-9479
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Country | US
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Telephone | 803-240-1967
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL JOSEPH RUGULEISKI
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Credential | LPC
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Telephone | 803-240-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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