Provider Demographics
NPI:1902396914
Name:JARELS, LINDA B (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:B
Last Name:JARELS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1392 DOGWOOD DIVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2042
Mailing Address - Country:US
Mailing Address - Phone:843-810-6478
Mailing Address - Fax:
Practice Address - Street 1:2323 SAINT MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2042
Practice Address - Country:US
Practice Address - Phone:803-534-0042
Practice Address - Fax:803-531-0676
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2879OtherBOARD OF EXAMINERS FOR COUNSELORS, THERAPISTS & PSYCHO-EDUCATIONAL SPECIALISTS