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General NPI Number Information
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NPI Number | 1104710805
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Entity Type | Organization
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Legal Business Name | WISE MIND CONSULTING, LLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 306 CHEROKEE RD
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City | FLORENCE
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State | SC
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Zip | 29501-5227
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Country | US
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Telephone | 843-731-7231
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Fax |
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Provider Business Mailing Address
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Address Line | 470 HARBOROUGH CT
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City | FLORENCE
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State | SC
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Zip | 29501-7531
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Country | US
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Telephone | 843-319-9490
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOROTHY M. SELMON
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Credential | LPC
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Telephone | 843-731-7231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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