MEDICARE: BRIGHTER HORIZONS COUNSELING, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1164986378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTER HORIZONS COUNSELING, LLC

Provider Business Mailing Address
First Line	:	3876 RENEE DR UNIT C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4108
Country	:	US
Telephone Number	:	843-504-8346
Fax Number	:	843-492-5533

Provider Business Practice Location Address
First Line	:	3876 RENEE DR UNIT C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4108
Country	:	US
Telephone Number	:	843-504-8346
Fax Number	:	843-492-5533

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN THOMAS KING
Credential	:	LISW-CP
Telephone Number	:	843-504-8346

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	03/13/2024

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