Provider Demographics
NPI:1225560790
Name:CARRINGTON, JEWELL ALLYSON (LPC, CACII)
Entity Type:Individual
Prefix:
First Name:JEWELL
Middle Name:ALLYSON
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:LPC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 PARKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-8130
Mailing Address - Country:US
Mailing Address - Phone:843-607-5153
Mailing Address - Fax:
Practice Address - Street 1:1500 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-8130
Practice Address - Country:US
Practice Address - Phone:843-607-5153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1403312101YA0400X
SC4262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)