Provider Demographics
NPI:1346093309
Name:PIECES 2 PEACE WELLNESS & CONSULTING LLC
Entity Type:Organization
Organization Name:PIECES 2 PEACE WELLNESS & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRINICIA
Authorized Official - Middle Name:RENEE' LAVON
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LPCS/C
Authorized Official - Phone:803-447-3949
Mailing Address - Street 1:PO BOX 9054
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29290-0054
Mailing Address - Country:US
Mailing Address - Phone:803-846-2499
Mailing Address - Fax:833-490-1311
Practice Address - Street 1:1109 BELLEVIEW ST STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1872
Practice Address - Country:US
Practice Address - Phone:803-846-2499
Practice Address - Fax:833-490-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health