MEDICARE: THE COUNSELING CENTER AT SEACOAST

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)
2	282J00000X	Religious Nonmedical Health Care Institution

General Provider Information

NPI Number	:	1467231795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE COUNSELING CENTER AT SEACOAST

Provider Business Mailing Address
First Line	:	713 LONG POINT RD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-8226
Country	:	US
Telephone Number	:	843-881-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	713 LONG POINT RD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-8226
Country	:	US
Telephone Number	:	843-881-2100
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE PASTOR
Name	:	ADAM MARTIN
Credential	:	DOCTOR
Telephone Number	:	843-881-2100

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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Directions to “THE COUNSELING CENTER AT SEACOAST ” Practice Location

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