Organization
KINTSUGI BEHAVIORAL HEALTH LLC
Active
Other names
Kintsugi Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE MAI LISW-CP (PSYCHOTHERAPIST)
(843) 410-9940
Entity
Organization
Contact information
Practice address
3301 SALTERBECK ST STE 101, MT PLEASANT, SC 29466-7165
(843) 410-9940
Mailing address
3301 SALTERBECK ST STE 101, MT PLEASANT, SC 29466-7165
(843) 410-9940
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/16/2024
Last updated
12/18/2024
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