Provider Demographics
NPI:1407184294
Name:PRICE, JANE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WOODRUFF ROAD
Mailing Address - Street 2:BUILDING A3 SUITE 178
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-678-4725
Mailing Address - Fax:864-288-7937
Practice Address - Street 1:1200 WOODRUFF ROAD
Practice Address - Street 2:BUILDING A-3 SUITE 178
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-678-4725
Practice Address - Fax:864-288-7937
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC#4801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional