| South Carolina Youth Advocate Program | |
|
140 Stoneridge Dr Columbia SC 29210-8200 | |
| (803) 779-5500 | |
| (803) 779-8444 |
| Full Name | South Carolina Youth Advocate Program |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 140 Stoneridge Dr, Columbia, South Carolina |
| Authorized Official Name and Position | Lex Cole (CEO) |
| Authorized Official Contact | 8037795500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina Youth Advocate Program 140 Stoneridge Dr Columbia SC 29210-8200 Ph: (803) 779-5500 | South Carolina Youth Advocate Program 140 Stoneridge Dr Columbia SC 29210-8200 Ph: (803) 779-5500 |
| NPI Number | 1477991941 |
|---|---|
| Provider Enumeration Date | 06/06/2013 |
| Last Update Date | 06/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477991941 | NPI | - | NPPES |
| 998MXH | Medicaid | SC | |
| GP6237 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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