Provider Demographics
NPI:1144793829
Name:NCK, LLC
Entity type:Organization
Organization Name:NCK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LISW-CP
Authorized Official - Phone:843-268-4848
Mailing Address - Street 1:1162 TURKEY TROT DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-8798
Mailing Address - Country:US
Mailing Address - Phone:843-990-6302
Mailing Address - Fax:
Practice Address - Street 1:1715 HOLLYDALE CT UNIT B
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-8319
Practice Address - Country:US
Practice Address - Phone:843-268-4848
Practice Address - Fax:843-305-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-06
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty