MEDICARE: BE THE CHANGE COUNSELING

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1659123610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE THE CHANGE COUNSELING

Provider Business Mailing Address
First Line	:	206 GEORGE BISHOP PKWY UNIT C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-7465
Country	:	US
Telephone Number	:	843-516-6757
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 GEORGE BISHOP PKWY UNIT C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-7465
Country	:	US
Telephone Number	:	843-516-6757
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	PAMELA BROWN
Credential	:	LISW-CP
Telephone Number	:	843-516-6757

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	04/03/2024

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