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NPI Code Detail

MEDICARE: KRISTAN BEGLIN CACII

MEDICARE: KRISTAN BEGLIN CACII
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1807261SC

General Provider Information

NPI Number : 1871071951
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTAN BEGLIN CACII
Provider Business Mailing Address
First Line : 89 COMMONS CT
Second Line :
City : PAWLEYS ISLAND
State : SC
Zip : 29585-6301
Country : US
Telephone Number : 843-235-1373
Fax Number :
Provider Business Practice Location Address
First Line : 104 GEORGE BISHOP PKWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-7335
Country : US
Telephone Number : 843-903-6212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2018
Last Update Date : 08/01/2018

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