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General NPI Number Information
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NPI Number | 1134522337
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Entity Type | Individual
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Provider Name | SHALETHA L RICHARD
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Gender | Female
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1228 HARDEN ST STE A
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City | COLUMBIA
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State | SC
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Zip | 29204-1800
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Country | US
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Telephone | 803-722-1565
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Fax | 803-888-1771
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Provider Business Mailing Address
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Address Line | PO BOX 3788
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City | COLUMBIA
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State | SC
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Zip | 29230-3788
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Country | US
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Telephone | 803-733-5969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9433
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | J082698428
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License Number State | OK
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