Provider Demographics
NPI:1851736730
Name:MCELVEEN, JACQUELINE ANN (BACHELOR)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:ANN
Last Name:MCELVEEN
Suffix:
Gender:F
Credentials:BACHELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MARTIN LUTHER KING AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-4103
Mailing Address - Country:US
Mailing Address - Phone:843-355-6525
Mailing Address - Fax:
Practice Address - Street 1:500 N ACADEMY ST
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3408
Practice Address - Country:US
Practice Address - Phone:843-355-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor