Healthcare Provider Details

I. General information

NPI: 1912830225
Provider Name (Legal Business Name): ECLECTIC WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104B W NORTH 1ST ST
SENECA SC
29678-3248
US

IV. Provider business mailing address

234 LITTLE CROWE CREEK RD
PICKENS SC
29671-9632
US

V. Phone/Fax

Practice location:
  • Phone: 864-533-4825
  • 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: TAMARA STAINTON
Title or Position: OWNER
Credential: LISW-CP, C-PD, C-DBT
Phone: 864-533-4825