Columbia Institute for Individual, Marriage and Family Therapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC # 22 Issued in SC

Legal business name

COLUMBIA INSTITUTE FOR INDIVIDUAL, MARRIAGE AND FAMILY THERAPY

Practice address

4 Lakecrest Dr
Columbia, SC 29206-1371

Phone

(803) 606-1123

Fax

(803) 790-7496

NPI assigned

Apr 26, 2007

Last updated

May 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Paul Carlson, M.DIV.,TH.D

Title

Director

Phone

(803) 606-1123

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1750501219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LAKECREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292061371",
            "telephone_number": "803-606-1123",
            "fax_number": "803-790-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LAKECREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292061371",
            "telephone_number": "803-606-1123",
            "fax_number": "803-790-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA INSTITUTE FOR INDIVIDUAL, MARRIAGE AND FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-606-1123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.DIV.,TH.D"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "LPC # 22",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Columbia Foot Clinic
• Columbia Gastroenterology Associates
• Columbia Gastroenterology Associates PA
• Columbia Hearing Center LLC
• Columbia Heart Clinic, PA (Columbia Heart Clinic)
• Columbia International University
• Columbia Medical Associates, P.a.
• Columbia Medical Group
• Columbia Medical Supplies, LLC
• Columbia Nephrology Associates PA

• Community/Behavioral Health Agency in Columbia, SC
• Providers in Columbia, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.