Healthcare Provider Details

I. General information

NPI: 1386511301
Provider Name (Legal Business Name): KRISTIE A VAN MEERBEKE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 N KINGS HWY STE 18
MYRTLE BEACH SC
29577-2740
US

IV. Provider business mailing address

594 STRAWBERRY FIELD WAY
GALIVANTS FERRY SC
29544-8082
US

V. Phone/Fax

Practice location:
  • Phone: 843-444-9095
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14163
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: