Provider Demographics
NPI:1558042739
Name:SEEDS OF DISCOVERY THERAPY, WELLNESS & CONSULTATION SERVICES LLC
Entity Type:Organization
Organization Name:SEEDS OF DISCOVERY THERAPY, WELLNESS & CONSULTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITLOW-BLANDING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-967-9313
Mailing Address - Street 1:4920 HARDSCRABBLE ROAD
Mailing Address - Street 2:APT 405
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9368
Mailing Address - Country:US
Mailing Address - Phone:803-967-9313
Mailing Address - Fax:803-769-7486
Practice Address - Street 1:1120 SPARKLEBERRY LANE EXT STE B
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7078
Practice Address - Country:US
Practice Address - Phone:803-967-9313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty