| Alive & Well Counseling, Llc | |
|
753 Johnnie Dodds Blvd Ste 100 Mt Pleasant SC 29464-3054 | |
| (864) 921-0744 | |
| Not Available |
| Full Name | Alive & Well Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 753 Johnnie Dodds Blvd Ste 100, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Jordan Watkins (OWNER & CLINICIAN) |
| Authorized Official Contact | 8649210744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alive & Well Counseling, Llc 4841 Cherry Blossom Dr Summerville SC 29485-8732 Ph: (864) 921-0744 | Alive & Well Counseling, Llc 753 Johnnie Dodds Blvd Ste 100 Mt Pleasant SC 29464-3054 Ph: (864) 921-0744 |
| NPI Number | 1356956650 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 09/14/2020 |
| Certification Date | 09/14/2020 |
| Medicare PECOS PAC ID | 4587082235 |
|---|---|
| Medicare Enrollment ID | O20200914000896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356956650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jordan H Watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265041313 PECOS PAC ID: 3577981158 Enrollment ID: I20200914002381 |
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