| Exquisite Minds Llc | |
|
101 Rice Bent Way Ste 11 Columbia SC 29229-6850 | |
| (803) 962-8621 | |
| Not Available |
| Full Name | Exquisite Minds Llc |
|---|---|
| Speciality | Counselor |
| Location | 101 Rice Bent Way Ste 11, Columbia, South Carolina |
| Authorized Official Name and Position | Tiffany D Johnson (OWNER,PROVIDER) |
| Authorized Official Contact | 8039625326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Exquisite Minds Llc 830 Weeks St Sumter SC 29150-6740 Ph: (803) 962-8621 | Exquisite Minds Llc 101 Rice Bent Way Ste 11 Columbia SC 29229-6850 Ph: (803) 962-8621 |
| NPI Number | 1861225450 |
|---|---|
| Provider Enumeration Date | 08/21/2024 |
| Last Update Date | 03/05/2025 |
| Certification Date | 03/05/2025 |
| Medicare PECOS PAC ID | 5991220360 |
|---|---|
| Medicare Enrollment ID | O20250417002176 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861225450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Tiffany Deanna Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457015612 PECOS PAC ID: 8022455799 Enrollment ID: I20240318003069 |
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