Organization
INTERNATIONAL CONSULTANT OF HEALTH AND EDUCATIONAL PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAKA ABDUL MOUSTAFA I PH.D (CEO)
(803) 477-7928
Entity
Organization
Contact information
Practice address
108 CAUGHMAN RIDGE RD, COLUMBIA, SC 29209-3114
(803) 477-7928
Mailing address
108 CAUGHMAN RIDGE RD, COLUMBIA, SC 29209-3114
(803) 477-7928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
Other
Enumeration date
06/21/2010
Last updated
03/14/2012
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