Provider Demographics
NPI:1699157362
Name:SHE'S COUNSELING TRICHOLOGY & CONSULTING LLC
Entity type:Organization
Organization Name:SHE'S COUNSELING TRICHOLOGY & CONSULTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/LICENSED CLINICAL THERAPIST SUP
Authorized Official - Prefix:
Authorized Official - First Name:RODSHENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-546-3896
Mailing Address - Street 1:2638 TWO NOTCH RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204
Mailing Address - Country:US
Mailing Address - Phone:803-638-3535
Mailing Address - Fax:
Practice Address - Street 1:2638 TWO NOTCH RD
Practice Address - Street 2:SUITE 210
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204
Practice Address - Country:US
Practice Address - Phone:803-936-1550
Practice Address - Fax:803-306-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6471101YM0800X
101YP2500X
SC6027251S00000X
SCDE3780332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP7557Medicaid