| Couples and Family Counseling & Wellness Center LLC | |
|
2105 Cromley Cir Ste B Myrtle Beach SC 29577-3168 | |
| (843) 995-9025 | |
| Not Available |
| Full Name | Couples and Family Counseling & Wellness Center LLC |
|---|---|
| Speciality | Counselor |
| Location | 2105 Cromley Cir Ste B, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Nicole Haunroth (OWNER) |
| Authorized Official Contact | 8439959025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Couples and Family Counseling & Wellness Center LLC 5049 Oat Fields Dr Myrtle Beach SC 29588-3720 Ph: (843) 995-9025 | Couples and Family Counseling & Wellness Center LLC 2105 Cromley Cir Ste B Myrtle Beach SC 29577-3168 Ph: (843) 995-9025 |
| NPI Number | 1558040048 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 07/13/2023 |
| Certification Date | 07/13/2023 |
| Medicare PECOS PAC ID | 6709377385 |
|---|---|
| Medicare Enrollment ID | O20251111002949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558040048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | () | Primary |
| Provider Name | Nicole Lynn Haunroth |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952869950 PECOS PAC ID: 8426549007 Enrollment ID: I20251111003201 |
| Provider Name | Benjamin Casola |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750873618 PECOS PAC ID: 1850642612 Enrollment ID: I20251112000041 |
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