MEDICARE: CREATING MEANING COUNSELING SERVICES LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1275282410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATING MEANING COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	4149 HIBISCUS DR APT 303
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-8384
Country	:	US
Telephone Number	:	347-575-8368
Fax Number	:

Provider Business Practice Location Address
First Line	:	4149 HIBISCUS DR APT 303
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-8384
Country	:	US
Telephone Number	:	347-575-8368
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUNE TYSON
Credential	:
Telephone Number	:	347-575-8368

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	02/14/2023

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