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General NPI Number Information
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NPI Number | 1447301114
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Entity Type | Organization
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Legal Business Name | PALMETTO ADVOCATES
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 2110 N BELTLINE BLVD
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City | COLUMBIA
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State | SC
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Zip | 29204-3999
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Country | US
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Telephone | 803-466-5223
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Fax |
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Provider Business Mailing Address
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Address Line | 7001 SAINT ANDREWS RD SUITE 319
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City | COLUMBIA
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State | SC
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Zip | 29212-1137
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Country | US
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Telephone | 803-466-5223
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE OFFICER
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Name | MR. KELVIN JOHNSON
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Credential |
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Telephone | 803-466-5223
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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 |
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License Number State |
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