Dazzetter Young Burnside

Individual provider Active NPI Mental Health Counselor · Greenville, SC

NPI 1487514162 · NPPES record last updated Nov 14, 2025

Key facts

NPI
1487514162
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
101 Cochran Dr
Greenville, SC 29611-5974
Phone
(864) 325-9223
NPI assigned
Nov 14, 2025
Sex
Female
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)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

101 Cochran Dr
Greenville, SC 29611-5974

Mailing address

101 Cochran Dr
Greenville, SC 29611-5974
Phone (864) 325-9223

Other providers in Greenville, SC

All providers in Greenville, SC · Mental Health Counselor in South Carolina

Sources for this page

Verify at the official NPI Registry.