Personal Healing and Mentoring

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PERSONAL HEALING AND MENTORING

Practice address

8887 Old University Blvd
North Charleston, SC 29406-7123

Phone

(843) 619-8872

NPI assigned

Jun 22, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Travis Thompson

Title

Chief Executive Officer

Phone

(843) 619-8872

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1699406363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HICKORY RIDGE WAY",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294839759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8887 OLD UNIVERSITY BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294067123",
            "telephone_number": "843-619-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL HEALING AND MENTORING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "843-619-8872",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.