Provider Demographics
NPI:1225230360
Name:NAGI, SAMUEL NJUGUNA (LPC, LPCS)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:NJUGUNA
Last Name:NAGI
Suffix:
Gender:M
Credentials:LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-0658
Mailing Address - Country:US
Mailing Address - Phone:803-333-9923
Mailing Address - Fax:803-333-9926
Practice Address - Street 1:7420 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-3017
Practice Address - Country:US
Practice Address - Phone:803-333-9923
Practice Address - Fax:803-333-9926
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2344101Y00000X, 101YM0800X
NC4893101YA0400X
101YP1600X, 106H00000X
SC2517101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCBT017Medicaid