| Organization Name: | CENTER FOR COUNSELING & WELLNESS |
| NPI Number: | 1538439450 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERTA J BOGLE (DIRECTOR) |
| Mailing Address: | 110 Ye Olde Kings Hwy North Myrtle Beach |
| State: | SC US |
| Postal Code: | 295823050 |
| Phone Number: | 8436630770 |
| Fax Number: | 8436630772 |
| NPI Enumeration Date: | 01/10/2012 |
| NPI Last Update Date: | 01/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 5005 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |