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General NPI Number Information
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NPI Number | 1558221713
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Entity Type | Organization
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Legal Business Name | ABLE SOUTH CAROLINA
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 720 GRACERN RD STE 106
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City | COLUMBIA
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State | SC
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Zip | 29210-7658
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Country | US
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Telephone | 803-779-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 720 GRACERN RD STE 106
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City | COLUMBIA
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State | SC
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Zip | 29210-7658
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Country | US
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Telephone | 803-779-5121
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CHIEF EXECUTIVE OFFICER
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Name | KIMBERLY TISSOT
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Credential |
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Telephone | 803-779-5121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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