Organization
INNOVATIVE SOLUTIONS CONSULTING & COUNSELING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINA CHANTE WILDY LPC (OWNER)
(803) 201-6771
Entity
Organization
Contact information
Practice address
661 BITTERNUT RD, COLUMBIA, SC 29209-4407
(803) 201-6771
(803) 569-6877
Mailing address
661 BITTERNUT RD, COLUMBIA, SC 29209-4407
(803) 201-6771
(803) 569-6877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5046
SC
101YP2500X
Professional Counselor
Primary
6057
SC
104100000X
Social Worker
7093
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1423
—
SC
Enumeration date
04/28/2015
Last updated
04/28/2015
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