Provider Demographics
NPI:1871646315
Name:JENNINGS, LINDA (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CARRIAGE LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-6048
Mailing Address - Country:US
Mailing Address - Phone:843-763-2222
Mailing Address - Fax:843-766-5705
Practice Address - Street 1:4 CARRIAGE LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6048
Practice Address - Country:US
Practice Address - Phone:843-763-2222
Practice Address - Fax:843-766-5705
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional