Provider Demographics
NPI:1396174702
Name:WOODLIEF, DARREN TODD (PHD)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:TODD
Last Name:WOODLIEF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 BULL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2506
Mailing Address - Country:US
Mailing Address - Phone:803-422-0017
Mailing Address - Fax:803-799-5596
Practice Address - Street 1:1816 BULL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2506
Practice Address - Country:US
Practice Address - Phone:803-422-0017
Practice Address - Fax:803-799-5596
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1534103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical