| Breathe Life Counseling | |
|
1495 Remount Rd Ste 3a North Charleston SC 29406-3320 | |
| (843) 882-6880 | |
| (843) 892-0394 |
| Full Name | Breathe Life Counseling |
|---|---|
| Speciality | Counselor |
| Location | 1495 Remount Rd Ste 3a, North Charleston, South Carolina |
| Authorized Official Name and Position | Stacey A Mullins (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5303143971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breathe Life Counseling 1495 Remount Rd Ste 3a North Charleston SC 29406-3320 Ph: (330) 807-7562 | Breathe Life Counseling 1495 Remount Rd Ste 3a North Charleston SC 29406-3320 Ph: (843) 882-6880 |
| NPI Number | 1649927492 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Medicare PECOS PAC ID | 2365881869 |
|---|---|
| Medicare Enrollment ID | O20240417000654 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649927492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Dena M Ewing |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598364218 PECOS PAC ID: 9739528241 Enrollment ID: I20240417001010 |
| Provider Name | Katherine L Gross |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578032843 PECOS PAC ID: 8628417128 Enrollment ID: I20240417001181 |
| Provider Name | Steven Jesse Jahnke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013532928 PECOS PAC ID: 5597104752 Enrollment ID: I20240419003310 |
| Provider Name | Angela M. O'rourke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558856591 PECOS PAC ID: 7719326214 Enrollment ID: I20240502000499 |
| Provider Name | Rex Alan Dula |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194335596 PECOS PAC ID: 6507206661 Enrollment ID: I20240507000237 |
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