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
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