Provider Demographics
NPI:1518488154
Name:PUROHIT, ASHA D (LISW-CP)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:D
Last Name:PUROHIT
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 ARDINCAPLE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-5446
Mailing Address - Country:US
Mailing Address - Phone:803-470-6334
Mailing Address - Fax:833-343-2134
Practice Address - Street 1:9 RICHLAND MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-434-6598
Practice Address - Fax:803-434-1920
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11388104100000X
SC143771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker