Provider Demographics
NPI:1962092999
Name:WEAVING THE WISDOM COACHING, COUNSELING, & CONSULTING, LLC
Entity type:Organization
Organization Name:WEAVING THE WISDOM COACHING, COUNSELING, & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:METTA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-214-6612
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-0016
Mailing Address - Country:US
Mailing Address - Phone:864-214-6612
Mailing Address - Fax:
Practice Address - Street 1:14 HOLLANDER DR
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-4601
Practice Address - Country:US
Practice Address - Phone:864-214-6612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1093205940OtherINDIVIDUAL NPI