| Etheria Counseling Llc | |
|
1551 21st Ave N Ste 17 Myrtle Beach SC 29577-7496 | |
| (843) 868-6200 | |
| (843) 868-6200 |
| Full Name | Etheria Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1551 21st Ave N Ste 17, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Angel Corbin (OWNER) |
| Authorized Official Contact | 8438686200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etheria Counseling Llc 1551 21st Ave N Ste 17 Myrtle Beach SC 29577-7496 Ph: (843) 868-6200 | Etheria Counseling Llc 1551 21st Ave N Ste 17 Myrtle Beach SC 29577-7496 Ph: (843) 868-6200 |
| NPI Number | 1609546613 |
|---|---|
| Provider Enumeration Date | 09/20/2021 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Medicare PECOS PAC ID | 0547793978 |
|---|---|
| Medicare Enrollment ID | O20241024000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609546613 | NPI | - | NPPES |
| Provider Name | Melissa Marie Muzzupappa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750820973 PECOS PAC ID: 6709299571 Enrollment ID: I20210115001957 |
| Provider Name | Angel Davis Corbin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699027961 PECOS PAC ID: 2365975794 Enrollment ID: I20241024000202 |
| Provider Name | James Edmond Garvey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861418683 PECOS PAC ID: 0143754655 Enrollment ID: I20241106002489 |
| Provider Name | Michael Hessler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447552971 PECOS PAC ID: 7113452681 Enrollment ID: I20241120002172 |
| Provider Name | Maryanne Zabrycki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063561082 PECOS PAC ID: 1153857198 Enrollment ID: I20241213000663 |
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