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General NPI Number Information
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NPI Number | 1598000333
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Entity Type | Organization
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Legal Business Name | FOREST ACRES COUNSELING CENTER LLC
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 5211 N TRENHOLM RD STE B
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City | COLUMBIA
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State | SC
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Zip | 29206-4815
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Country | US
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Telephone | 803-240-1990
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 AUTUMN CIR
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City | COLUMBIA
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State | SC
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Zip | 29206-4995
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Country | US
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Telephone | 803-240-1990
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROL BARNETT
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Credential | LISW
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Telephone | 803-240-1990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1141
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License Number State | SC
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