Provider Demographics
NPI: | 1871632281 |
---|---|
Name: | SWEAT, VIOLET ELIZABETH (LPC, CAC I, CRC) |
Entity type: | Individual |
Prefix: | |
First Name: | VIOLET |
Middle Name: | ELIZABETH |
Last Name: | SWEAT |
Suffix: | |
Gender: | F |
Credentials: | LPC, CAC I, CRC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 914 RICHLAND ST STE B201 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBIA |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29201-2393 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 803-629-2201 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 914 RICHLAND ST STE B201 |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBIA |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29201-2393 |
Practice Address - Country: | US |
Practice Address - Phone: | 803-629-2201 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-02-05 |
Last Update Date: | 2010-05-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
SC | 4607 | 101YA0400X, 101YM0800X, 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |