Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 2344 | SC |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 4893 | NC |
N | 101YM0800X | Mental Health Counselor | 2344 | SC |
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor | 2517 | SC |
NPI | 1225230360 |
---|---|
Provider Name | Dr. Samuel Njuguna Nagi |
First Address | Irmo, SC 29063-0658 |
Second Address | Columbia, SC 29203-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CBT017 | (05) | SC |