MEDICARE: CHRISTOPHER WELLS MS, LPC-A

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	101YM0800X	Mental Health Counselor	8098	SC

General Provider Information

NPI Number	:	1104513217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER WELLS MS, LPC-A

Provider Business Mailing Address
First Line	:	644 GOODLET CIR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-8329
Country	:	US
Telephone Number	:	843-452-4287
Fax Number	:

Provider Business Practice Location Address
First Line	:	890 JOHNNIE DODDS BLVD STE A
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-6129
Country	:	US
Telephone Number	:	843-884-3888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2023
Last Update Date	:	04/19/2023

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