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General NPI Number Information
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NPI Number | 1285126847
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Entity Type | Organization
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Legal Business Name | ANXIETY & DEPRESSION CLINIC OF COLUMBIA
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 2600 FORUM BLVD STE G
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City | COLUMBIA
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State | MO
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Zip | 65203-6343
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Country | US
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Telephone | 573-239-9915
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Fax | 573-340-1028
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Provider Business Mailing Address
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Address Line | 2600 FORUM BLVD STE G
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City | COLUMBIA
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State | MO
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Zip | 65203-6343
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Country | US
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Telephone | 573-239-9915
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Fax | 573-340-1028
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Authorized Official
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Title or Position | OWNER
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Name | JARED B TORBET
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Credential | LPC
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Telephone | 573-239-9915
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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 | 2010042076
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License Number State | MO
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