# WACCAMAWS HEALTH AND WELLNESS SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124371448
- **Authorized official:** PROF. LAKEYSA MARIE JOHNSON CAC-P, MSW, LISW-CP (CEO/PSYCHOTHERAPIST)
- **Authorized official phone:** (843) 279-0172

## Contact information

- **Practice address:** 314A LAUREL ST, SUITE 205, CONWAY, SC 29526-5157
- **Practice address phone:** (843) 279-0172
- **Practice address fax:** (843) 438-5386
- **Mailing address:** 314A LAUREL ST, SUITE 205, CONWAY, SC 29526-5157
- **Mailing address phone:** (843) 279-0172
- **Mailing address fax:** (843) 438-5386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 7334 | SC | Yes |

## Other

- **Enumeration date:** 10/24/2012
- **Last updated:** 06/18/2013