Provider Demographics
NPI:1336502988
Name:NWC COUNSELING LLC
Entity Type:Organization
Organization Name:NWC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-295-0609
Mailing Address - Street 1:1671 RABON FARMS LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5880
Mailing Address - Country:US
Mailing Address - Phone:803-295-0609
Mailing Address - Fax:
Practice Address - Street 1:2212 DEVINE ST
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2402
Practice Address - Country:US
Practice Address - Phone:803-295-0609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5720101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1560Medicaid