# NORTHEAST COLUMBIA PSYCHOTHERAPY PRACTICE INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Norheast Columbia Psychotherapy Practice, Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255390001
- **Authorized official:** BETH TROY MARIS MSW (THERAPIST/PRESIDENT)
- **Authorized official phone:** (803) 736-7133

## Contact information

- **Practice address:** 9 POACHERS LANE, COLUMBIA, SC 29223-3014
- **Practice address phone:** (803) 736-7133
- **Mailing address:** 9 POACHERS LANE, COLUMBIA, SC 29223-3014
- **Mailing address phone:** (803) 736-7133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | LISW-CP 134 | SC | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 08/11/2022