Provider Demographics
NPI:1194112920
Name:A PIECE OF MIND COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:A PIECE OF MIND COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROF. COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:N
Authorized Official - Last Name:CANTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC,CFC,BCPC,DAPA
Authorized Official - Phone:843-318-0380
Mailing Address - Street 1:3944 HIGHWAY 17
Mailing Address - Street 2:UNIT 7
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5094
Mailing Address - Country:US
Mailing Address - Phone:843-318-0380
Mailing Address - Fax:843-947-0812
Practice Address - Street 1:3944 HIGHWAY 17
Practice Address - Street 2:UNIT 7
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5094
Practice Address - Country:US
Practice Address - Phone:843-318-0380
Practice Address - Fax:843-947-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3958101YP2500X
SC4342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1227Medicaid