Healthcare Provider Details

I. General information

NPI: 1417878562
Provider Name (Legal Business Name): ANCHORED MIND THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 16TH AVE NW STE 114
SURFSIDE BEACH SC
29575-5284
US

IV. Provider business mailing address

1012 16TH AVE NW STE 114
SURFSIDE BEACH SC
29575-5284
US

V. Phone/Fax

Practice location:
  • Phone: 609-247-6968
  • Fax:
Mailing address:
  • Phone: 609-247-6968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAMMY START
Title or Position: CEO
Credential:
Phone: 609-247-6968