Active NPI
Staci Jill Quan, M.ED. M.A. LPC
- Counselor
- Columbia, SC
National Provider Identifier
1699016741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 5811
- Practice address
- 2113 Adams Grove Ste 110
Columbia, SC 29203 - Phone
- (803) 256-1737
- NPI assigned
- Mar 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 5811 | SC | Primary |
Addresses
Primary practice location
2113 Adams Grove Ste 110
Columbia, SC 29203
Mailing address
1809 Heyward St.
Columbia, SC 29205
Phone (803) 414-5591
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts, Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5811 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1699016741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1809 HEYWARD ST.",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29205",
"telephone_number": "803-414-5591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2113 ADAMS GROVE STE 110",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-256-1737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUAN",
"first_name": "STACI",
"middle_name": "JILL",
"credential": "M.ED. M.A. LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-13",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "SC",
"license": "5811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.