1003425570 NPI number — INFINITE SOLUTIONS COUNSELING AND CONSULTING LLC

Table of content: (NPI 1003425570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003425570 NPI number — INFINITE SOLUTIONS COUNSELING AND CONSULTING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INFINITE SOLUTIONS COUNSELING AND CONSULTING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003425570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2141
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRMO
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29063-7141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-319-0910
Provider Business Mailing Address Fax Number:
803-563-5930

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7803 SAINT ANDREWS ROAD
Provider Second Line Business Practice Location Address:
SUITE C2
Provider Business Practice Location Address City Name:
IRMO
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-319-0910
Provider Business Practice Location Address Fax Number:
803-403-0337
Provider Enumeration Date:
07/30/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SKINNER
Authorized Official First Name:
SUZANNE
Authorized Official Middle Name:
MICHELLE
Authorized Official Title or Position:
OWNER/PSYCHOTHERAPIST
Authorized Official Telephone Number:
803-319-0910

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)