MEDICARE: PALMETTO COUNSELING AND WELLNESS 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1497612725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMETTO COUNSELING AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	436 N DUNCAN BYP STE A
Second Line	:
City	:	UNION
State	:	SC
Zip	:	29379-8604
Country	:	US
Telephone Number	:	864-441-0014
Fax Number	:	864-658-5367

Provider Business Practice Location Address
First Line	:	436 N DUNCAN BYP STE A
Second Line	:
City	:	UNION
State	:	SC
Zip	:	29379-8604
Country	:	US
Telephone Number	:	864-441-0014
Fax Number	:	864-658-5367

Authorized Official
Title or Position	:	CEO
Name	:	MARIANNE THOMPSON BUMGARNER
Credential	:	LPC
Telephone Number	:	803-944-1575

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	04/07/2026

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