# MIDLANDS WELLNESS, LLC

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

## Provider details

- **NPI number:** 1255101598
- **Authorized official:** STEPHANIE ROBERTS LISW-CP (OWNER)
- **Authorized official phone:** (803) 720-9151

## Contact information

- **Practice address:** 528 BROAD ST STE 101, SUMTER, SC 29150-3368
- **Practice address phone:** (803) 720-9151
- **Mailing address:** 25 KILLARNEY LN, SUMTER, SC 29150-7050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2024
- **Last updated:** 01/08/2024