Organization
CONCRETE CLINICAL SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAMIQUIA NIKIA MCPHERSON LPCS (EXECUTIVE DIRECTOR)
(803) 881-5599
Entity
Organization
Contact information
Practice address
1627 AUBURN ST., COLUMBIA, SC 29204
(803) 881-5599
(803) 724-6758
Mailing address
PO BOX 50579, SUMMERVILLE, SC 29485-0579
(803) 881-5599
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
SC
Enumeration date
09/15/2020
Last updated
09/15/2020
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