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General NPI Number Information
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NPI Number | 1730346057
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Entity Type | Organization
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Legal Business Name | COOPER-LEWTER CONSULTING LLC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 120 WILDEWOOD PARK DR SUITE A
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City | COLUMBIA
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State | SC
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Zip | 29223-4313
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Country | US
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Telephone | 803-462-7181
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Fax | 803-462-7181
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Provider Business Mailing Address
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Address Line | 120 WILDWOD PARK DR SUITE A
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City | COLUMBIA
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State | SC
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Zip | 29223-4313
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Country | US
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Telephone | 803-462-7181
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Fax | 803-462-7181
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | DR. NICHOLAS COOPER-LEWTER
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Credential | MSW PHD LISW-CP
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Telephone | 803-462-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006957
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License Number State | SC
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