| M3 Ventures, Llc | |
|
508 Hampton St Ste 203 Columbia SC 29201-2765 | |
| (706) 910-2570 | |
| Not Available |
| Full Name | M3 Ventures, Llc |
|---|---|
| Speciality | Counselor |
| Location | 508 Hampton St Ste 203, Columbia, South Carolina |
| Authorized Official Name and Position | Charla Brooks (OWNER) |
| Authorized Official Contact | 7069102570 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M3 Ventures, Llc Po Box 1641 Evans GA 30809-1641 Ph: () - | M3 Ventures, Llc 508 Hampton St Ste 203 Columbia SC 29201-2765 Ph: (706) 910-2570 |
| NPI Number | 1144910845 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 05/08/2023 |
| Certification Date | 05/08/2023 |
| Medicare PECOS PAC ID | 3173965142 |
|---|---|
| Medicare Enrollment ID | O20240522000456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144910845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lakeshia Michelle Terry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316680416 PECOS PAC ID: 0547602559 Enrollment ID: I20240522002162 |
| Provider Name | Jessica C Vann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316434772 PECOS PAC ID: 6800238874 Enrollment ID: I20240522003099 |
| Provider Name | Stephanie Nicole Benenhaley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306496765 PECOS PAC ID: 2668914706 Enrollment ID: I20240605000499 |
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