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General NPI Number Information
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NPI Number | 1194112920
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Entity Type | Organization
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Legal Business Name | A PIECE OF MIND COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 3944 HIGHWAY 17 UNIT 7
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City | MURRELLS INLET
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State | SC
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Zip | 29576-5094
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Country | US
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Telephone | 843-318-0380
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Fax | 843-947-0812
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Provider Business Mailing Address
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Address Line | 3944 HIGHWAY 17 UNIT 7
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City | MURRELLS INLET
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State | SC
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Zip | 29576-5094
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Country | US
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Telephone | 843-318-0380
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Fax | 843-947-0812
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Authorized Official
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Title or Position | OWNER/LICENSED PROF. COUNSELOR
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Name | AMY N CANTLEY
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Credential | LPC,CFC,BCPC,DAPA
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Telephone | 843-318-0380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4342
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3958
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License Number State | SC
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