Provider Demographics
NPI:1881953727
Name:MINTER, JAMIE (LISW-CP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MINTER
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 CHICORA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-2904
Mailing Address - Country:US
Mailing Address - Phone:803-237-3339
Mailing Address - Fax:
Practice Address - Street 1:140 STONERIDGE DR
Practice Address - Street 2:STE 210
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-8270
Practice Address - Country:US
Practice Address - Phone:570-239-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0172721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical