Healthcare Provider Details

I. General information

NPI: 1609796747
Provider Name (Legal Business Name): ENLIGHTENED MIND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 MISSISSIPPI AVE
AIKEN SC
29801-3103
US

IV. Provider business mailing address

2917 MISSISSIPPI AVE
AIKEN SC
29801-3103
US

V. Phone/Fax

Practice location:
  • Phone: 803-770-8471
  • Fax:
Mailing address:
  • Phone: 803-770-8471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARIANNE MATOS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 803-770-8471