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General NPI Number Information
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NPI Number | 1134824311
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Entity Type | Organization
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Legal Business Name | OLIVE BRANCH COUNSELING
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 2712 MIDDLEBURG DR STE 207B
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City | COLUMBIA
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State | SC
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Zip | 29204-2445
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Country | US
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Telephone | 803-546-3504
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Fax | 803-653-3376
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Provider Business Mailing Address
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Address Line | 106 CARLYLE CIR
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City | COLUMBIA
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State | SC
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Zip | 29206-3145
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Country | US
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Telephone | 803-563-7550
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Fax |
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Authorized Official
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Title or Position | THERAPIST/SOLE PROP
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Name | LAUREN MARIE ROSINSKI
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Credential | LISW-CP
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Telephone | 803-563-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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