Jazz & Coco LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

JAZZ & COCO LLC

Doing business as

Jim Bennett Counselor

Practice address

289 Highway 90 E Unit H
Little River, SC 29566-9298

Phone

(843) 685-0998

Fax

(843) 695-7681

NPI assigned

Aug 27, 2019

Last updated

Aug 27, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

JAZZ & COCO LLCAs reported in NPPES

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

Authorized official

Name

Mr. James Bradford Bennett, MA,LPC,NCC,MAC,LACNPI 1528475266

Title

Owner Clinician

Phone

(304) 610-8661

Specialties & licenses 1

Addresses

Other names 1

• Jim Bennett Counselor Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Part of

Jazz Coco LLC

Locations

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.

• James Bennett

  • Mental Health Counselor
  • Little River, SC
  • NPI 1528475266
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1376191098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 HIGHWAY 90 E UNIT H",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669298",
            "telephone_number": "843-685-0998",
            "fax_number": "843-695-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 HIGHWAY 90 E UNIT H",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669298",
            "telephone_number": "843-685-0998",
            "fax_number": "843-695-7681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAZZ & COCO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAZZ & COCO LLC",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "OWNER CLINICIAN",
        "authorized_official_telephone_number": "304-610-8661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA,LPC,NCC,MAC,LAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jim Bennett Counselor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gillian Marie Hyde, PA-C
• Elaian Berneshia Hypolite
• Brenden Jackson
• Gianna Marie Jacullo, OTR/L
• Leah Jarrett, OTR/L
• Autumn McKenzie Johnson, MAT, LAT, ATC
• David M. Johnson, MD
• Joined Together Marriage& Family LLC
• Denise Regina Kalin, L.M.T.
• Amanda Bullock Kanipe, FNP-BC

• Mental Health Counselor in Little River, SC
• Providers in Little River, 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 Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.