Provider Demographics
NPI:1518977040
Name:LOWE-JENKINS, ALESIA ANTOINETTE (LPCS)
Entity Type:Individual
Prefix:MRS
First Name:ALESIA
Middle Name:ANTOINETTE
Last Name:LOWE-JENKINS
Suffix:
Gender:F
Credentials:LPCS
Other - Prefix:MS
Other - First Name:ALESIA
Other - Middle Name:ANTOINETTE
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 B. WEST BUTLER RD. STE 278
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662
Mailing Address - Country:US
Mailing Address - Phone:864-625-1152
Mailing Address - Fax:864-606-0083
Practice Address - Street 1:364 S PINE ST A10
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302
Practice Address - Country:US
Practice Address - Phone:864-625-1152
Practice Address - Fax:864-606-0083
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3333Medicare ID - Type Unspecified
SC301100Medicaid