Peaceful Foundations Wellness Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PEACEFUL FOUNDATIONS WELLNESS CENTER LLC

Practice address

3255 Landmark Dr
North Charleston, SC 29418-8461

Phone

(843) 466-4420

Fax

(843) 989-0427

NPI assigned

Jun 7, 2025

Last updated

Apr 27, 2026By 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

Tasha M Frederick, LISW-CPNPI 1215132733

Title

Owner

Phone

(803) 543-3660

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

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.

• Tasha Michelle Frederick, LISW-CP

  • Clinical Social Worker
  • North Charleston, SC
  • NPI 1215132733
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1749254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1720972219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8211 PLEASANT RIDGE DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294208326",
            "telephone_number": "803-543-3660",
            "fax_number": "843-989-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 LANDMARK DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294188461",
            "telephone_number": "843-466-4420",
            "fax_number": "843-989-0427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8211 Pleasant Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294208326",
            "country_code": "US",
            "telephone_number": "843-466-4420",
            "fax_number": "843-989-0427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEACEFUL FOUNDATIONS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-07",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-543-3660",
        "authorized_official_credential": "LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SW1054",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna S Patterson, NP-C
• Lillian Patton
• Paul W Derrick, OD PA
• Sarath Pavuluri
• Paige Lanier Payne, PT
• Peaceful Retreat Home LLC
• Christina Maria Pearce, LISC-CP
• Pearl Rehabilitation LLC
• Yernequa Lashayne Pearson
• Allison Peart, PA-C

• Clinical Social Worker in North Charleston, SC
• Providers in North Charleston, 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 Apr 27, 2026; 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.