Mr James Bennett, | |
289 Highway 90 E Unit H, Little River, SC 29566-9298 | |
(843) 685-0998 | |
(843) 695-7681 |
Full Name | Mr James Bennett |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 289 Highway 90 E Unit H, Little River, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528475266 | NPI | - | NPPES |
PC1631 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 5807 (South Carolina) | Primary |
Entity Name | Jazz & Coco Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376191098 PECOS PAC ID: 8729426796 Enrollment ID: O20240410000542 |
Mailing Address | Practice Location Address |
---|---|
Mr James Bennett, 289 Highway 90 E Unit H, Little River, SC 29566-9298 Ph: (304) 610-8661 | Mr James Bennett, 289 Highway 90 E Unit H, Little River, SC 29566-9298 Ph: (843) 685-0998 |
Mrs. Vickie Eldridge Purdy, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1629 Highway 17, Little River, SC 29566 Phone: 361-494-4171 | |
Margaret Angelique Fahy-rawlinson, LPC, LPC/S, LMT Counselor Medicare: Not Enrolled in Medicare Practice Location: 34 Highway 90 E, Little River, SC 29566 Phone: 843-446-6222 Fax: 843-734-0638 | |
Mr. Jeffrey Dwayne Randall, MPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 501 Highway 90 E, Little River, SC 29566 Phone: 803-422-7231 | |
Christian Mcphail, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4452 Live Oak Dr, Little River, SC 29566 Phone: 803-479-4629 | |
Mrs. Ellen Cecil King, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 289 Highway 90 E Unit H, Little River, SC 29566 Phone: 843-685-0998 | |
Susan Kaye Crisp, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4303 Live Oak Dr, Little River, SC 29566 Phone: 843-663-8000 |