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General NPI Number Information
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NPI Number | 1831901024
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Entity Type | Organization
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Legal Business Name | ASPIRE CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 1314 LEESBURG RD STE C
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City | COLUMBIA
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State | SC
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Zip | 29209-2255
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Country | US
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Telephone | 803-445-8960
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 LEESBURG RD STE C
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City | COLUMBIA
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State | SC
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Zip | 29209-2255
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Country | US
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Telephone | 803-445-8960
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Fax |
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Authorized Official
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Title or Position | FOUNDER/ CEO
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Name | MRS. LATOYA EDWARDS
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Credential | LPC
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Telephone | 803-445-8960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 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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