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General NPI Number Information
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NPI Number | 1285430678
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Entity Type | Organization
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Legal Business Name | K4 CONSULTING AND COUNSELING GROUP LLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 9005 TWO NOTCH RD STE 13
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City | COLUMBIA
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State | SC
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Zip | 29223-5850
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Country | US
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Telephone | 803-572-7112
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Fax |
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Provider Business Mailing Address
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Address Line | 4012 MORNING DEW RD
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City | ELGIN
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State | SC
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Zip | 29045-4304
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Country | US
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Telephone | 803-572-7112
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Fax |
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Authorized Official
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Title or Position | LEAD PROVIDER
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Name | MILISSA DAVIS
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Credential | PMHNP
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Telephone | 803-764-0791
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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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