| Jazz & Coco Llc | |
|
289 Highway 90 E Unit H Little River SC 29566-9298 | |
| (843) 685-0998 | |
| (843) 695-7681 |
| Full Name | Jazz & Coco Llc |
|---|---|
| Speciality | Counselor |
| Location | 289 Highway 90 E Unit H, Little River, South Carolina |
| Authorized Official Name and Position | James Bradford Bennett (OWNER CLINICIAN) |
| Authorized Official Contact | 3046108661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jazz & Coco Llc 289 Highway 90 E Unit H Little River SC 29566-9298 Ph: (843) 685-0998 | Jazz & Coco Llc 289 Highway 90 E Unit H Little River SC 29566-9298 Ph: (843) 685-0998 |
| NPI Number | 1376191098 |
|---|---|
| Provider Enumeration Date | 08/27/2019 |
| Last Update Date | 08/27/2019 |
| Medicare PECOS PAC ID | 8729426796 |
|---|---|
| Medicare Enrollment ID | O20240410000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376191098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | James Bennett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528475266 PECOS PAC ID: 9638517600 Enrollment ID: I20240410000787 |
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