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General NPI Number Information
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NPI Number | 1437701364
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Entity Type | Organization
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Legal Business Name | COLUMBIA PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1331 ELMWOOD AVE STE 300B
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City | COLUMBIA
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State | SC
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Zip | 29201-2150
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Country | US
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Telephone | 803-250-5109
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 ELMWOOD AVE STE 300B
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City | COLUMBIA
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State | SC
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Zip | 29201-2150
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Country | US
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Telephone | 803-250-5109
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICK BAGNELL
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Credential |
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Telephone | 803-250-5109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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