Healthcare Provider Details

I. General information

NPI: 1154264398
Provider Name (Legal Business Name): THE WELLNESS COLLECTIVE INTEGRATED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

IV. Provider business mailing address

215 CALLIBLUFF DR
SUMMERVILLE SC
29486-0439
US

V. Phone/Fax

Practice location:
  • Phone: 585-813-9916
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KAYLA ERNST
Title or Position: OWNER
Credential: LPC
Phone: 585-813-9916