MEDICARE: AT THE WELL COUNSELING 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1912862624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT THE WELL COUNSELING LLC

Provider Business Mailing Address
First Line	:	6650 RIVERS AVE SUITE 105
Second Line	:	PMB 943841
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-4829
Country	:	US
Telephone Number	:	803-386-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	248 CASSIQUE DR
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-7041
Country	:	US
Telephone Number	:	803-386-9120
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. STEPHEN WAYNE HOWERTON
Credential	:	MA, LPC-A, NCC
Telephone Number	:	803-386-9120

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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