Provider Demographics
NPI:1255995908
Name:OGLESBY, MARIAN (LPC)
Entity type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:
Last Name:OGLESBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 MIDDLEBURG DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2405
Mailing Address - Country:US
Mailing Address - Phone:803-376-8875
Mailing Address - Fax:
Practice Address - Street 1:2701 MIDDLEBURG DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2405
Practice Address - Country:US
Practice Address - Phone:803-376-8875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health