Healthcare Provider Details

I. General information

NPI: 1790220382
Provider Name (Legal Business Name): MINISTRIES FOR SYNERGETIC WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2017
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 BLADEN ST
BEAUFORT SC
29902-4915
US

IV. Provider business mailing address

PO BOX 4256
BEAUFORT SC
29903-4256
US

V. Phone/Fax

Practice location:
  • Phone: 843-770-9947
  • Fax: 843-525-6116
Mailing address:
  • Phone: 843-770-9947
  • Fax: 843-525-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6335
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number6335
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number6335
License Number StateSC

VIII. Authorized Official

Name: MS. RENEE EVADNE SUTTON
Title or Position: PRESIDENT
Credential: LPC
Phone: 843-770-9947