Organization
COLUMBIA INSTITUTE FOR INDIVIDUAL, MARRIAGE AND FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM PAUL CARLSON M.DIV.,TH.D (DIRECTOR)
(803) 606-1123
Entity
Organization
Contact information
Practice address
4 LAKECREST DR, COLUMBIA, SC 29206-1371
(803) 606-1123
(803) 790-7496
Mailing address
4 LAKECREST DR, COLUMBIA, SC 29206-1371
(803) 606-1123
(803) 790-7496
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC # 22
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
—
Enumeration date
04/26/2007
Last updated
05/21/2020
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