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General NPI Number Information
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NPI Number | 1285125757
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Entity Type | Organization
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Legal Business Name | CAROLINA COUNSELING CONSULTANTS
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 7356 GARNERS FERRY RD STE 112
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City | COLUMBIA
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State | SC
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Zip | 29209-2146
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Country | US
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Telephone | 803-463-7652
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23783
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City | COLUMBIA
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State | SC
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Zip | 29224-3783
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | CHRISTALYN HOWARD
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Credential |
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Telephone | 803-463-7652
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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 | 6746
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License Number State | SC
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