Provider Demographics
NPI:1225215973
Name:ALLEN, JENNIFER T (MSW, LISW-CP-S)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:T
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MSW, LISW-CP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W ASHFORD CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8328
Mailing Address - Country:US
Mailing Address - Phone:803-727-4224
Mailing Address - Fax:
Practice Address - Street 1:1401 1/2 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2509
Practice Address - Country:US
Practice Address - Phone:803-727-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical