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General NPI Number Information
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NPI Number | 1821737354
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Entity Type | Organization
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Legal Business Name | PHOENIX COUNSELING AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 1721 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29407-5943
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Country | US
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Telephone | 843-209-8840
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Fax |
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Provider Business Mailing Address
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Address Line | 520 FOLLY RD STE 25
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City | CHARLESTON
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State | SC
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Zip | 29412-3019
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Country | US
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Telephone | 856-209-8840
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CHRISTINE CONTI
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Credential | LPC
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Telephone | 843-209-8840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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