Healthcare Provider Details

I. General information

NPI: 1497612725
Provider Name (Legal Business Name): PALMETTO COUNSELING AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N DUNCAN BYP STE A
UNION SC
29379-8604
US

IV. Provider business mailing address

436 N DUNCAN BYP STE A
UNION SC
29379-8604
US

V. Phone/Fax

Practice location:
  • Phone: 864-441-0014
  • Fax: 864-658-5367
Mailing address:
  • Phone: 864-441-0014
  • Fax: 864-658-5367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIANNE THOMPSON BUMGARNER
Title or Position: CEO
Credential: LPC
Phone: 803-944-1575