MEDICARE: THE WELLNESS COLLECTIVE INTEGRATED SERVICES 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1154264398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WELLNESS COLLECTIVE INTEGRATED SERVICES LLC

Provider Business Mailing Address
First Line	:	215 CALLIBLUFF DR
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-0439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6650 RIVERS AVE STE 100
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	585-813-9916
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KAYLA ERNST
Credential	:	LPC
Telephone Number	:	585-813-9916

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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