Integrative Wellness

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5584 Issued in SC

Legal business name

INTEGRATIVE WELLNESS

Practice address

4406B Forest Dr
Suite 104
Columbia, SC 29206-3104

Phone

(803) 414-5652

Fax

(803) 359-6265

NPI assigned

Nov 29, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sherri Dickson-Jefferson, LPC

Title

Owner

Phone

(803) 414-5652

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385683200000",
    "number": "1275964389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406B FOREST DR",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063104",
            "telephone_number": "803-414-5652",
            "fax_number": "803-359-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4406B FOREST DR",
            "address_2": "SUITE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063104",
            "telephone_number": "803-414-5652",
            "fax_number": "803-359-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-29",
        "last_updated": "2013-11-29",
        "status": "A",
        "authorized_official_last_name": "DICKSON-JEFFERSON",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-414-5652",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Columbia, SC
• Providers in Columbia, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.