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NPI 1437195963

NPI 1437195963 : FAMILY MATTERS LLC : COLUMBIA, SC

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General NPI Number Information
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    NPI Number           |    1437195963
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    Entity Type          |    Organization 
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    Legal Business Name  |    FAMILY MATTERS LLC 
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Dates
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    Enumeration Date     |    06/22/2006
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    Last Update Date     |    09/29/2015
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Provider Practice Location Address
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    Address Line         |    2016 ASSEMBLY ST 
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    City                 |    COLUMBIA
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    State                |    SC
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    Zip                  |    29201-2142
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    Country              |    US
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    Telephone            |    803-251-0368
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 8561 
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    City                 |    COLUMBIA
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    State                |    SC
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    Zip                  |    29202-8561
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    Country              |    US
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    Telephone            |    803-251-0368
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. NICOLE WILLIS SNELL 
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    Credential           |    LPC
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    Telephone            |    803-251-0368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    4056
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    License Number State |    SC
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Taxonomy #2
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    4056
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    License Number State |    SC
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Taxonomy #3
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    4056
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    License Number State |    SC
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