MEDICARE: MEETING MILESTONES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1063127124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEETING MILESTONES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 443
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29465-0443
Country	:	US
Telephone Number	:	803-524-9715
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 BELLE POINT DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-8266
Country	:	US
Telephone Number	:	803-524-9715
Fax Number	:

Authorized Official
Title or Position	:	BCBA AND CEO
Name	:	KASEY GRAHAM PETERSEN
Credential	:	BCBA
Telephone Number	:	803-524-9715

Provider Enumeration Date	:	01/23/2023
Last Update Date	:	01/23/2023

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Directions to “MEETING MILESTONES, LLC ” Practice Location

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