Healthcare Provider Details

I. General information

NPI: 1033073986
Provider Name (Legal Business Name): COLLECTIVE CONSCIOUS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PORT CITY LNDG STE 2011
MOUNT PLEASANT SC
29464-1872
US

IV. Provider business mailing address

75 PORT CITY LNDG STE 2011
MOUNT PLEASANT SC
29464-1872
US

V. Phone/Fax

Practice location:
  • Phone: 843-284-6160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALLYRAE CONLEY
Title or Position: THERAPIST & FOUNDER
Credential: LISW-CP
Phone: 843-284-6160