NPIMap

Organization Active NPI

Foundations Counseling and Wellness Center, LLC

  • Clinical Social Worker
  • Goose Creek, SC
National Provider Identifier
1023604964
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FOUNDATIONS COUNSELING AND WELLNESS CENTER, LLC
Practice address
105 Central Ave Ste 18100-B
Goose Creek, SC 29445-3084
Phone
(854) 588-5710
Fax
(843) 429-8998
NPI assigned
Dec 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
Mrs. Alicia Ruth Zorn, LISW-CP
Title
Owner/Therapist
Phone
(843) 588-5710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

105 Central Ave Ste 18100-B
Goose Creek, SC 29445-3084

Mailing address

105 Central Ave Ste 18100-B
Goose Creek, SC 29445-3084
Phone (854) 588-5710

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1023604964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CENTRAL AVE STE 18100-B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453084",
            "telephone_number": "854-588-5710",
            "fax_number": "843-429-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CENTRAL AVE STE 18100-B",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453084",
            "telephone_number": "854-588-5710",
            "fax_number": "843-429-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS COUNSELING AND WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "ZORN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "843-588-5710",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.