Organization
FOUNDATIONS FAMILY LIFE COUNSELING AND CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA LYNN WALDROP MFT, MA (CEO)
(803) 814-6218
Entity
Organization
Contact information
Practice address
2917 MILLWOOD AVE # B, COLUMBIA, SC 29205-1334
(803) 814-6218
Mailing address
222 COATBRIDGE DR, BLYTHEWOOD, SC 29016-9582
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609303650
MFT
SC
Enumeration date
09/19/2018
Last updated
09/19/2018
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