Individual
MR. JOHN KHRISTOPHER COOLIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW-CP, CAC I
Contact information
Practice address
UNIVERSITY OF SOUTH CAROLINA, COUNSELING & HUMAN DEVELOPMENT CENTER, BYRNES BLDG., COLUMBIA, SC 29208-0001
(803) 777-5223
(803) 777-5433
Mailing address
515 LAUREL HILL LN, COLUMBIA, SC 29201-1241
(803) 929-0886
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6407
SC
Other
Enumeration date
05/13/2009
Last updated
07/21/2009
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