Provider Demographics
NPI:1346974383
Name:HIGH HOPES MENTAL WELLNESS ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HIGH HOPES MENTAL WELLNESS ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:COURTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-530-3564
Mailing Address - Street 1:3970 CAESARS RD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29170-1312
Mailing Address - Country:US
Mailing Address - Phone:803-530-3564
Mailing Address - Fax:
Practice Address - Street 1:989 KNOX ABBOTT DR STE 112
Practice Address - Street 2:
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-3346
Practice Address - Country:US
Practice Address - Phone:803-828-0775
Practice Address - Fax:803-756-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8340OtherLICENSE NUMBER