Organization
SECOND WIND LIFE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA L COSTILLA LPC (OWNER/COUNSELOR)
(843) 695-9997
Entity
Organization
Contact information
Practice address
1140 BOONE HILL RD STE A, SUMMERVILLE, SC 29483-2402
(843) 695-9997
(854) 300-4965
Mailing address
275 CHEYENNE RD, SUMMERVILLE, SC 29483-8301
(843) 695-9997
(854) 300-4965
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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