Provider Demographics
NPI:1821090812
Name:HIGHTOWER, MARJORIE M (PHD LPC SCRN RNCS)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:M
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:PHD LPC SCRN RNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 UPPER POND RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-3026
Mailing Address - Country:US
Mailing Address - Phone:803-736-4883
Mailing Address - Fax:803-865-7083
Practice Address - Street 1:1829 MARION ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2527
Practice Address - Country:US
Practice Address - Phone:803-252-3420
Practice Address - Fax:803-865-7083
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC928101YP2500X
SC208685163WP0809X
SC41,401163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Not Answered163W00000XNursing Service ProvidersRegistered Nurse