Provider Demographics
NPI:1720603640
Name:WITCHER, DANIEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:WITCHER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 CHADFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063
Mailing Address - Country:US
Mailing Address - Phone:803-760-8702
Mailing Address - Fax:
Practice Address - Street 1:1200 MAIN ST STE 914
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-6203
Practice Address - Country:US
Practice Address - Phone:803-250-5134
Practice Address - Fax:803-234-2969
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7498101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health