Provider Demographics
NPI:1902549975
Name:PEACE & HARMONY EMOTIONAL WELLBEING LLC
Entity Type:Organization
Organization Name:PEACE & HARMONY EMOTIONAL WELLBEING LLC
Other - Org Name:PEACE & HARMONY EMOTIONAL WELLBEING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:MS
Authorized Official - First Name:MONTRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURENTON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:803-766-4800
Mailing Address - Street 1:4464 DEVINE ST STE M
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-3605
Mailing Address - Country:US
Mailing Address - Phone:803-766-4800
Mailing Address - Fax:803-766-4900
Practice Address - Street 1:6650 RIVERS AVE SUITE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406
Practice Address - Country:US
Practice Address - Phone:803-753-1472
Practice Address - Fax:803-598-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1902549975Medicaid