# PLAY THERAPY WITH CARMEN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OUTSPOKEN COUNSELING AND CONSULTING LLC
- **Other names:** Carmen JImenez
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679009559
- **Legal business name:** OUTSPOKEN COUNSELING AND CONSULTING LLC
- **Authorized official:** CARMEN JIMENEZ LISW, LCSW, RPTS (FOUNDER)
- **Authorized official phone:** (980) 275-2505

## Contact information

- **Practice address:** 300 BERKSHIRE DR STE F, COLUMBIA, SC 29223-1859
- **Practice address phone:** (980) 275-2505
- **Mailing address:** PO BOX 8804, COLUMBIA, SC 29202-8804
- **Mailing address phone:** (980) 275-2505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 10478 | SC | Yes |
| 1041C0700X | Clinical Social Worker | C008505 | SC | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 05/11/2017