Provider Demographics
NPI:1710081153
Name:MAHIDA, NANCY CAMPBELL (LPC, LPC-S, CACII)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CAMPBELL
Last Name:MAHIDA
Suffix:
Gender:F
Credentials:LPC, LPC-S, CACII
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:C
Other - Last Name:MAHIDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED, LPC, LPC-S
Mailing Address - Street 1:219 HUMAN SERVICES RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:SC
Mailing Address - Zip Code:29325-7548
Mailing Address - Country:US
Mailing Address - Phone:864-833-6500
Mailing Address - Fax:864-833-6905
Practice Address - Street 1:219 HUMAN SERVICES RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7548
Practice Address - Country:US
Practice Address - Phone:864-833-6500
Practice Address - Fax:864-833-6905
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2382101YP2500X
SC5223101YP2500X
SCCERT # 12122110101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC421504Medicaid