Provider Demographics
NPI:1508217381
Name:GIFT COUNSELING CENTER FOR WELLNESS, LLC
Entity Type:Organization
Organization Name:GIFT COUNSELING CENTER FOR WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BEALS
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, LPC, NCC
Authorized Official - Phone:937-212-8304
Mailing Address - Street 1:119 MANLY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3024
Mailing Address - Country:US
Mailing Address - Phone:864-534-1224
Mailing Address - Fax:864-438-1357
Practice Address - Street 1:119 MANLY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3024
Practice Address - Country:US
Practice Address - Phone:864-534-1224
Practice Address - Fax:864-438-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2016-36083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty