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SOUTH CAROLINA YOUTH ADVOCATE PROGRAM NPI 1477991941


NPI Information

NPI: 1477991941
Provider Name: SOUTH CAROLINA YOUTH ADVOCATE PROGRAM
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 42D2158713

Address:
140 STONERIDGE DR
COLUMBIA, SC
ZIP 29210
Phone: (803) 779-5500
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SOUTH CAROLINA YOUTH ADVOCATE PROGRAM is a clinical social worker in Columbia, SC. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SOUTH CAROLINA YOUTH ADVOCATE PROGRAM NPI is 1477991941. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

140 STONERIDGE DR
COLUMBIA, SC
ZIP 29210-200
Phone: (803) 779-5500
Fax: (803) 779-8444

The provider's authorized official is Lex Cole .
The authorized official title is Ceo and has the following contact phone number (803) 779-5500.

The CLIA number assigned to this NPI record is 42D2158713 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/6/2013 and was last updated on 6/27/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessionalNo
21041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP6237MEDICAIDSOUTH CAROLINA
2998MXHMEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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