Individual
KADIE ANN BOURGOIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1817 PICKENS ST, COLUMBIA, SC 29201-2630
(803) 356-0134
(803) 401-5424
Mailing address
1817 PICKENS ST, COLUMBIA, SC 29201-2630
(803) 356-0134
(803) 401-5424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
13044
FL
101YP2500X
Professional Counselor
Primary
7631
SC
Other
Enumeration date
06/15/2020
Last updated
03/27/2025
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