Provider Demographics
NPI:1083150494
Name:A PLACE 2 SMILE LLC
Entity Type:Organization
Organization Name:A PLACE 2 SMILE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:L-MSW
Authorized Official - Phone:843-364-1107
Mailing Address - Street 1:1 CARRIAGE LN
Mailing Address - Street 2:BUILDING E SUITE 107
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6060
Mailing Address - Country:US
Mailing Address - Phone:843-556-4449
Mailing Address - Fax:
Practice Address - Street 1:1 CARRIAGE LN
Practice Address - Street 2:BUILDING E SUITE 107
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6060
Practice Address - Country:US
Practice Address - Phone:843-556-4449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9399251B00000X, 251K00000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency