Healthcare Provider Details

I. General information

NPI: 1912862624
Provider Name (Legal Business Name): AT THE WELL COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 CASSIQUE DR
LEXINGTON SC
29073-7041
US

IV. Provider business mailing address

6650 RIVERS AVE SUITE 105 PMB 943841
NORTH CHARLESTON SC
29406-4829
US

V. Phone/Fax

Practice location:
  • Phone: 803-386-9120
  • Fax:
Mailing address:
  • Phone: 803-386-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

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