Provider Demographics
NPI:1316761778
Name:LEAVES ON A STREAM COUNSELING, LLC
Entity type:Organization
Organization Name:LEAVES ON A STREAM COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:803-250-5430
Mailing Address - Street 1:501 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1354
Mailing Address - Country:US
Mailing Address - Phone:803-250-5430
Mailing Address - Fax:
Practice Address - Street 1:1817 PICKENS ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2630
Practice Address - Country:US
Practice Address - Phone:803-250-5430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health