Healthcare Provider Details

I. General information

NPI: 1235059825
Provider Name (Legal Business Name): NEW VISION BEHAVIORAL HEALTH WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 HIGHWAY 301 N
DILLON SC
29536-2958
US

IV. Provider business mailing address

506 HIGHWAY 301 N
DILLON SC
29536-2958
US

V. Phone/Fax

Practice location:
  • Phone: 843-627-3038
  • Fax: 843-627-3028
Mailing address:
  • Phone: 843-627-3038
  • Fax: 843-627-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANING BETHEA
Title or Position: OWNER
Credential:
Phone: 843-702-7344