Healthcare Provider Details

I. General information

NPI: 1194635052
Provider Name (Legal Business Name): KERRY WISCHUSEN COUNSELING & MINDFULNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 BELLE ISLE AVE
MOUNT PLEASANT SC
29464-8336
US

IV. Provider business mailing address

717 BRUCERIDGE LN
HUGER SC
29450-9308
US

V. Phone/Fax

Practice location:
  • Phone: 843-242-0622
  • Fax:
Mailing address:
  • Phone: 908-347-0501
  • 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: KERRY ROSE WISCHUSEN
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC, MA
Phone: 843-242-0622