Khadijah Asiya Abdul-Qawee

Individual provider Active NPI Behavior Technician · Columbia, SC

NPI 1033909171 · NPPES record last updated May 12, 2025

Key facts

NPI
1033909171
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3401 Colonial Dr
Columbia, SC 29203-6934
Phone
(803) 339-1907
Fax
(803) 394-5619
NPI assigned
May 12, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Bardin Behavioral Health, LLC Current
since May 18, 2025
Accepting new patients

Locations

3401 Colonial Dr
Columbia, SC 29203
Phone (803) 339-1907

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3401 Colonial Dr
Columbia, SC 29203-6934

Mailing address

3401 Colonial Dr
Columbia, SC 29203-6934
Phone (803) 339-1907

Other providers in Columbia, SC

All providers in Columbia, SC · Behavior Technician in South Carolina

Sources for this page

Verify at the official NPI Registry.