Destination Fortified Counseling & Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DESTINATION FORTIFIED COUNSELING & WELLNESS, LLC

Practice address

114 Holstein LN
Columbia, SC 29209-5089

Phone

(803) 238-6856

NPI assigned

Sep 10, 2025

Last updated

Sep 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nicolette D Burnette, LISW-CPNPI 1073299954

Title

Clinician

Phone

(803) 238-6856

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicolette D Burnette, LISW

  • Clinical Social Worker
  • Columbia, SC
  • NPI 1073299954
  NPD Authorized official

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1245111871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HOLSTEIN LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292095089",
            "telephone_number": "803-238-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HOLSTEIN LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292095089",
            "telephone_number": "803-238-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINATION FORTIFIED COUNSELING & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-08-28",
        "status": "A",
        "authorized_official_last_name": "BURNETTE",
        "authorized_official_first_name": "NICOLETTE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "803-238-6856",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Columbia, SC
• Providers in Columbia, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.