Provider Demographics
NPI:1336963230
Name:ESSENCE THERAPY LLC
Entity type:Organization
Organization Name:ESSENCE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISW-CP
Authorized Official - Prefix:
Authorized Official - First Name:LEXUS
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-293-8780
Mailing Address - Street 1:336 GEORGIA AVE
Mailing Address - Street 2:STE 106 PMB 195
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:607 HAMPTON DR
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860
Practice Address - Country:US
Practice Address - Phone:806-634-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health