Provider Demographics
NPI:1780229146
Name:WILDFLOWER CENTER FOR COUNSELING
Entity Type:Organization
Organization Name:WILDFLOWER CENTER FOR COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-936-2566
Mailing Address - Street 1:774 S SHELMORE BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7625
Mailing Address - Country:US
Mailing Address - Phone:843-936-2566
Mailing Address - Fax:843-800-0073
Practice Address - Street 1:774 S SHELMORE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7625
Practice Address - Country:US
Practice Address - Phone:843-936-2566
Practice Address - Fax:843-800-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty