Organization
MODERN MINDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER BURGETT (DIRECTOR, PRACTICE OPERATIONS)
(843) 531-9036
Entity
Organization
Contact information
Practice address
40 CALHOUN ST STE 240, CHARLESTON, SC 29401-3534
(843) 531-9036
(833) 358-1254
Mailing address
40 CALHOUN ST STE 240, CHARLESTON, SC 29401-3534
(843) 531-9036
(833) 358-1254
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
171400000X
Health & Wellness Coach
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000-000-0000
NO OTHER NUMBERS TO DECLARE
—
Enumeration date
02/08/2022
Last updated
02/08/2022
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