Healthcare Provider Details

I. General information

NPI: 1841085909
Provider Name (Legal Business Name): RAGIN WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 MASTERS DR
SUMTER SC
29154-7700
US

IV. Provider business mailing address

249 MASTERS DR
SUMTER SC
29154-7700
US

V. Phone/Fax

Practice location:
  • Phone: 803-410-8240
  • Fax:
Mailing address:
  • Phone: 803-410-8240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANIDRA TIANA RAGIN
Title or Position: THERAPIST
Credential: LMSW
Phone: 803-410-8240