Healthcare Provider Details

I. General information

NPI: 1437078193
Provider Name (Legal Business Name): MENDING THROUGH DISCOVERY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 BARNES STATION RD
IVA SC
29655-8070
US

IV. Provider business mailing address

1428 BARNES STATION RD
IVA SC
29655-8070
US

V. Phone/Fax

Practice location:
  • Phone: 864-309-3471
  • Fax:
Mailing address:
  • Phone: 864-309-3471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. CYNTHIA M DEVINE
Title or Position: OWNER
Credential: LCP-A
Phone: 864-309-3471