Charleston Mental Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHARLESTON MENTAL WELLNESS, LLC

Practice address

25 Cumberland St Ste 120
Charleston, SC 29401-2039

Phone

(843) 367-3490

NPI assigned

Jun 24, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ashley Lauderdale, LPC

Title

Owner, Therapist

Phone

(843) 367-3490

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435104000000",
    "number": "1013399203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CUMBERLAND ST STE 120",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294012039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CUMBERLAND ST STE 120",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294012039",
            "telephone_number": "843-367-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON MENTAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A",
        "authorized_official_last_name": "LAUDERDALE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "843-367-3490",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Charleston, SC
• Providers in Charleston, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.