Provider Demographics
NPI:1659675452
Name:TROUTMAN, OMAR A (PHD, LPC, LPCS)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:A
Last Name:TROUTMAN
Suffix:
Gender:M
Credentials:PHD, LPC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SADDLEBROOKE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7854
Mailing Address - Country:US
Mailing Address - Phone:803-240-8310
Mailing Address - Fax:803-526-7628
Practice Address - Street 1:409 SADDLEBROOKE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7854
Practice Address - Country:US
Practice Address - Phone:803-240-8310
Practice Address - Fax:803-526-7628
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5122101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional