Provider Demographics
NPI:1053285643
Name:STATES OF WELLBEING
Entity type:Organization
Organization Name:STATES OF WELLBEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STATES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:304-482-4826
Mailing Address - Street 1:810 CAROLINA FARMS BLVD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-3568
Mailing Address - Country:US
Mailing Address - Phone:304-482-4826
Mailing Address - Fax:843-484-3831
Practice Address - Street 1:176 VILLAGE CENTER BLVD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-5622
Practice Address - Country:US
Practice Address - Phone:304-482-4826
Practice Address - Fax:843-484-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty