Provider Demographics
NPI:1447747456
Name:JEANNA ROBBINS, LPC, COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:JEANNA ROBBINS, LPC, COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC, CCMHC
Authorized Official - Phone:803-381-5637
Mailing Address - Street 1:1110 KINLEY RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9633
Mailing Address - Country:US
Mailing Address - Phone:803-381-5637
Mailing Address - Fax:803-753-0041
Practice Address - Street 1:1110 KINLEY RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-9633
Practice Address - Country:US
Practice Address - Phone:803-381-5637
Practice Address - Fax:803-753-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5608101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1339Medicaid