| Advanced Practice Mental Health And Wellness | |
|
630 Chestnut Rd Myrtle Beach SC 29572-5502 | |
| (843) 945-1452 | |
| (843) 945-1489 |
| Full Name | Advanced Practice Mental Health And Wellness |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 630 Chestnut Rd, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Laura L Crawford (DIRECTOR) |
| Authorized Official Contact | 8439451452 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Practice Mental Health And Wellness 630 Chestnut Rd # 14 Myrtle Beach SC 29572-5502 Ph: (843) 945-1452 | Advanced Practice Mental Health And Wellness 630 Chestnut Rd Myrtle Beach SC 29572-5502 Ph: (843) 945-1452 |
| NPI Number | 1790284990 |
|---|---|
| Provider Enumeration Date | 02/03/2018 |
| Last Update Date | 09/19/2023 |
| Certification Date | 09/19/2023 |
| Medicare PECOS PAC ID | 7719312065 |
|---|---|
| Medicare Enrollment ID | O20200115002036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790284990 | NPI | - | NPPES |
| 7004896 | Medicaid | NC |
| Provider Name | Robin Starr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053384537 PECOS PAC ID: 8527959006 Enrollment ID: I20160722000517 |
| Provider Name | Ashley A Harrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396110599 PECOS PAC ID: 1456648088 Enrollment ID: I20160927000162 |
| Provider Name | Milissa P Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558992701 PECOS PAC ID: 9133541873 Enrollment ID: I20200625000591 |
| Provider Name | Rose Carpenzano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326393745 PECOS PAC ID: 5294147666 Enrollment ID: I20201209002799 |
| Provider Name | Elena Huttenlocher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194175992 PECOS PAC ID: 9436540093 Enrollment ID: I20211216000050 |
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