Provider Demographics
NPI:1619256047
Name:VILLAGE CONCEPTS CONSULTANTS, LLC
Entity Type:Organization
Organization Name:VILLAGE CONCEPTS CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGENIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAWLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-417-8239
Mailing Address - Street 1:PO BOX 291003
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-0017
Mailing Address - Country:US
Mailing Address - Phone:803-417-8239
Mailing Address - Fax:803-834-7031
Practice Address - Street 1:303 LAKE CAROLINA BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7549
Practice Address - Country:US
Practice Address - Phone:803-417-8239
Practice Address - Fax:803-834-7031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106498101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty