Provider Demographics
NPI:1437761160
Name:FROM SURVIVING TO THRIVING, LLC
Entity Type:Organization
Organization Name:FROM SURVIVING TO THRIVING, LLC
Other - Org Name:FROM SURVIVING TO THRIVING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAVON
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LAC, MAC, CACI
Authorized Official - Phone:843-379-0545
Mailing Address - Street 1:35 PARRIS ISLAND GTWY # 104
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-4244
Mailing Address - Country:US
Mailing Address - Phone:843-379-0545
Mailing Address - Fax:
Practice Address - Street 1:35 PARRIS ISLAND GTWY # 104
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-4244
Practice Address - Country:US
Practice Address - Phone:843-217-5691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty