Koshon Mitchell
Individual provider Active NPI Pastoral Counselor · Graniteville, SC
NPI 1184569402 · NPPES record last updated Apr 22, 2026
Key facts
- NPI
- 1184569402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pastoral Counselor 101YP1600X
- Practice address
- 1040 Hayes Dr
Graniteville, SC 29829-3856 - Phone
- (843) 302-9947
- NPI assigned
- Apr 22, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor |
101YP1600X | Yes | ||
| Mental Health Counselor |
101YM0800X |
Addresses
Primary practice location
1040 Hayes Dr
Graniteville, SC 29829-3856
Mailing address
1040 Hayes Dr
Graniteville, SC 29829-3856
Phone (843) 302-9947
Other providers in Graniteville, SC
- Darrell William Jones
- Love Legacy Care LLC
- Kayla McElmurray
- Jennifer Rebecca Messina
- Midland Valley Behavioral Health & Consulting, LLC
- Shatori Moore
- Alexa Myers
- Tyler Reed Myers
- Angela Odom
- Destiny Patten
All providers in Graniteville, SC · Pastoral Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.