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General NPI Number Information
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NPI Number | 1972399202
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Entity Type | Organization
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Legal Business Name | THE ESTEEMED COLLECTIVE LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1612 MARION ST STE 100G
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City | COLUMBIA
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State | SC
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Zip | 29201-2939
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Country | US
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Telephone | 803-528-3836
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Fax |
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Provider Business Mailing Address
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Address Line | 6650 RIVERS AVE STE 105 #431671
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ERIN LATRESCE TOLBERT
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Credential | LPC/S
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Telephone | 803-528-3836
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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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