MEDICARE: JOY IN THE MOURNING 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	4713	SC

General Provider Information

NPI Number	:	1457573867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY IN THE MOURNING LLC

Provider Business Mailing Address
First Line	:	117 COLLINS DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-8316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 LAKE MURRAY BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-0951
Country	:	US
Telephone Number	:	803-407-3185
Fax Number	:	803-407-3581

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LINDA SWAIN GILL
Credential	:	LPC
Telephone Number	:	803-407-3185

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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Directions to “JOY IN THE MOURNING LLC ” Practice Location

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