MEDICARE: TRUSTED RESULTS THERAPY GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	104100000X	Social Worker
3	101YM0800X	Mental Health Counselor
4	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1427736404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTED RESULTS THERAPY GROUP LLC

Provider Business Mailing Address
First Line	:	1071 SEA EAGLE WATCH
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-8252
Country	:	US
Telephone Number	:	843-793-2104
Fax Number	:	843-654-4850

Provider Business Practice Location Address
First Line	:	2000 SAM RITTENBURG BLVD
Second Line	:	SUITE 2011
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4631
Country	:	US
Telephone Number	:	843-793-2104
Fax Number	:	843-654-4850

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MITZI WARD
Credential	:
Telephone Number	:	910-234-1742

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	06/09/2026

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Directions to “TRUSTED RESULTS THERAPY GROUP LLC ” Practice Location

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