Basic Information
| Provider Information | |||||||||
| NPI: | 1962973768 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KEY | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | R. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2414 BULL ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292011906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8038982461 | ||||||||
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| Practice Location | |||||||||
| Address1: | LEXINGTON COMMUNITY MENTAL HEALTH CENTER | ||||||||
| Address2: | 301 PALMETTO PARK BOULEVARD | ||||||||
| City: | LEXINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8039961500 | ||||||||
| FaxNumber: | 8039961510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2018 | ||||||||
| LastUpdateDate: | 12/06/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.