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General NPI Number Information
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NPI Number | 1588639652
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Entity Type | Individual
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Provider Name | NICOLE WILLIS SNELL LPC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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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 |
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Name |
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Credential |
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4056
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License Number State | SC
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Taxonomy #4
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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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