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General NPI Number Information
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NPI Number | 1114326469
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Entity Type | Organization
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Legal Business Name | CASON PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 140 SUMMIT CENTRE DR SUITE B
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City | COLUMBIA
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State | SC
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Zip | 29229-7612
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Country | US
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Telephone | 803-404-8756
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Fax | 803-526-7323
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Provider Business Mailing Address
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Address Line | 140 SUMMIT CENTRE DR SUITE B
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City | COLUMBIA
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State | SC
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Zip | 29229-7612
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Country | US
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Telephone | 803-404-8756
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Fax | 803-526-7323
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Authorized Official
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Title or Position | OWNER
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Name | DANA CASON
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Credential |
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Telephone | 803-404-8756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1115
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License Number State | SC
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