| NPI | 1699326645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE JOHNSON Owner 843-260-4904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| 102L00000X Psychoanalyst | |
| 103K00000X Behavior Analyst | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist, Clinical | |
| 103TF0000X Psychologist, Family | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |