| Doctor Name: | MRS. LUCY VICIOSO-HARRIS |
| NPI Number: | 1508227653 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC-INTERN |
| License Number: | 6143 |
| Business Practice Address: | 1443 Highway 1 S Lugoff, SC - 290789460 |
| Business Phone Number: | 8037080902 |
| Business Fax Number: | 8034038965 |
| Mailing Address: | 487 Town Center Pl, Apt 215 COLUMBIA |
| State: | SC |
| Postal Code: | 292297973 |
| Phone Number: | 8037080902 |
| Fax Number: | 8034038965 |
| NPI Enumeration Date: | 03/17/2016 |
| NPI Last Update Date: | 03/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |