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NPI Code Detail

MEDICARE: DR. NICOLE WILLIS SNELL LPC

MEDICARE:  DR. NICOLE WILLIS SNELL  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor4056SC
2101YM0800XMental Health Counselor4056SC
3101YP2500XProfessional Counselor4056SC
4106H00000XMarriage & Family Therapist4056SC

General Provider Information

NPI Number : 1588639652
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE WILLIS SNELL LPC
Provider Business Mailing Address
First Line : PO BOX 8561
Second Line :
City : COLUMBIA
State : SC
Zip : 29202-8561
Country : US
Telephone Number : 803-251-0368
Fax Number :
Provider Business Practice Location Address
First Line : 2016 ASSEMBLY ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2142
Country : US
Telephone Number : 803-251-0368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 09/29/2015

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Directions to “ DR. NICOLE WILLIS SNELL LPC” Practice Location

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