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NPI Code Detail

MEDICARE: YOUR THERAPY WORKS LLC,

MEDICARE: YOUR THERAPY WORKS 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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1194310664
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUR THERAPY WORKS LLC,
Provider Business Mailing Address
First Line : 4325 DICK POND RD STE C
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-6810
Country : US
Telephone Number : 843-655-7463
Fax Number :
Provider Business Practice Location Address
First Line : 4325 DICK POND RD STE C
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-6810
Country : US
Telephone Number : 843-655-7463
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MRS. ELENA HUTTENLOCHER
Credential : LISW-CP
Telephone Number : 843-655-7463
Provider Enumeration Date : 03/05/2021
Last Update Date : 03/05/2021

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Directions to “YOUR THERAPY WORKS LLC, ” Practice Location

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