Provider Demographics
NPI:1306129879
Name:AYERS, RICKEY GENE (LPC)
Entity type:Individual
Prefix:
First Name:RICKEY
Middle Name:GENE
Last Name:AYERS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 FOREST DRIVE
Mailing Address - Street 2:C
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206
Mailing Address - Country:US
Mailing Address - Phone:803-606-7171
Mailing Address - Fax:
Practice Address - Street 1:1800 FOREST DRIVE
Practice Address - Street 2:C
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206
Practice Address - Country:US
Practice Address - Phone:803-606-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral