Organization
COLUMBIA PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK BAGNELL (OWNER)
(803) 250-5109
Entity
Organization
Contact information
Practice address
1331 ELMWOOD AVE STE 300B, COLUMBIA, SC 29201-2150
(803) 250-5109
Mailing address
1331 ELMWOOD AVE STE 300B, COLUMBIA, SC 29201-2150
(803) 250-5109
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TS0200X
School Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/11/2019
Last updated
03/10/2026
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