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General NPI Number Information
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NPI Number | 1104507144
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Entity Type | Organization
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Legal Business Name | PHOENIX PHILOSOPHIES COUNSELING & CONSULTING LLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 6169 SAINT ANDREWS RD STE 40
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City | COLUMBIA
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State | SC
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Zip | 29212-3146
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Country | US
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Telephone | 803-683-7986
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Fax |
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Provider Business Mailing Address
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Address Line | 6169 SAINT ANDREWS RD STE 40
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City | COLUMBIA
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State | SC
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Zip | 29212-3146
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Country | US
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Telephone | 803-402-6947
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/OWNER
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Name | MS. TAMARA JACOBS
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Credential | LPC-A
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Telephone | 803-402-6947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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