Phelps, Kenneth W

Phelps, Kenneth W is an individual health care provider with primary practice located at 3555 Harden Street Ext 15 Medical Park, Suite 141, Columbia SC 29203-6894. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Phelps, Kenneth W can be contacted via phone (803) 434-4221.

Contact Information

Primary practice address
3555 Harden Street Ext 15 Medical Park, Suite 141 Columbia SC 29203-6894
Phone: (803) 434-4221
Fax: (803) 434-4351
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4520 South Carolina
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1309 North Carolina

Profile Details

NPI number 1942439302
LBN Legal business name Phelps, Kenneth W
Credentials PHD, LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2009
Last updated Nov 12th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1942439302 NPPES
South Carolina MEDICAID LT1001

Popular Providers