MEDICARE: OCEANSUN COUNSELING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1437242534	OTHER	SC	REBECCA MCCRUDDEN
2	1891964946	OTHER	SC	DAN ROTUNDA
3	1114984721	OTHER	SC	JEAN SCHURLKNIGHT

General Provider Information

NPI Number	:	1053582304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANSUN COUNSELING CENTER

Provider Business Mailing Address
First Line	:	815 SAVANNAH HWY STE 202
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7351
Country	:	US
Telephone Number	:	843-556-4541
Fax Number	:	843-556-1599

Provider Business Practice Location Address
First Line	:	815 SAVANNAH HWY STE 202
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7351
Country	:	US
Telephone Number	:	843-556-4541
Fax Number	:	843-556-1599

Authorized Official
Title or Position	:	CLINICAL COUNSELOR
Name	:	MRS. JEAN MARIA SCHURLKNIGHT
Credential	:	LPC RPT
Telephone Number	:	843-556-4541

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	03/14/2008

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Directions to “OCEANSUN COUNSELING CENTER ” Practice Location

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