Organization
SOUTH CAROLINA YOUTH ADVOCATE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEX COLE (CEO)
(803) 779-5500
Entity
Organization
Contact information
Practice address
140 STONERIDGE DR, COLUMBIA, SC 29210-8200
(803) 779-5500
(803) 779-8444
Mailing address
140 STONERIDGE DR, COLUMBIA, SC 29210-8200
(803) 779-5500
(803) 779-8444
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
998MXH
—
SC
05
—
GP6237
—
SC
Enumeration date
06/06/2013
Last updated
06/27/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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