Organization
LRC FOR SUBSTANCE ABUSE & BEHAVIORAL PROBS.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY P. MCFADDEN (OWNER)
(803) 740-9298
Entity
Organization
Contact information
Practice address
1105 BELLEVIEW ST., COLUMBIA, SC 29202
(803) 740-9298
(803) 223-9420
Mailing address
PO BOX 8724, 1105 BELLEVIEW ST., COLUMBIA, SC 29202
(803) 740-9298
(803) 223-9420
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
OPT-0097
SC
101YM0800X
Mental Health Counselor
OPT-0097
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7000128742
QPL#
SC
Enumeration date
11/13/2009
Last updated
11/13/2009
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