Provider Demographics
NPI:1831461490
Name:STOVER, JAMIE LEA (LPCS, CCLS)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LEA
Last Name:STOVER
Suffix:
Gender:F
Credentials:LPCS, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 CAMMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1911
Mailing Address - Country:US
Mailing Address - Phone:864-350-6772
Mailing Address - Fax:
Practice Address - Street 1:222 CAMMER AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1911
Practice Address - Country:US
Practice Address - Phone:864-350-6772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-29
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5743101YP2500X
SC5361101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional