Provider Demographics
NPI:1841572245
Name:FIRM FOUNDATIONS COUNSELING & WELLNESS
Entity type:Organization
Organization Name:FIRM FOUNDATIONS COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:843-267-6035
Mailing Address - Street 1:5 LAKE CAROLINA WAY
Mailing Address - Street 2:SUITE 280
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7561
Mailing Address - Country:US
Mailing Address - Phone:803-708-0902
Mailing Address - Fax:803-403-8965
Practice Address - Street 1:5 LAKE CAROLINA WAY
Practice Address - Street 2:SUITE 280
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7561
Practice Address - Country:US
Practice Address - Phone:803-708-0902
Practice Address - Fax:803-403-8965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5241101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1132Medicaid