Provider Demographics
NPI:1225856792
Name:SEASIDE REFLECTIONS COUNSELING, LLC
Entity type:Organization
Organization Name:SEASIDE REFLECTIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUZZUPAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CPS, LCSW-C, LC
Authorized Official - Phone:443-926-6387
Mailing Address - Street 1:6650 RIVERS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4809
Mailing Address - Country:US
Mailing Address - Phone:843-258-3976
Mailing Address - Fax:
Practice Address - Street 1:357 SEAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-6759
Practice Address - Country:US
Practice Address - Phone:843-258-3976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty