1699934307 NPI number — MRS. JEAN C. WHEELER MA, LPC

Table of content: MRS. JEAN C. WHEELER MA, LPC (NPI 1699934307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699934307 NPI number — MRS. JEAN C. WHEELER MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHEELER
Provider First Name:
JEAN
Provider Middle Name:
C.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699934307
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2298 SERENITY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCK HILL
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29730-6575
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-366-2577
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2298 SERENITY LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCK HILL
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29730-6575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-366-2577
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LPC 1559 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LPC 1559 . This is a "BOARD OF EXAMINERS FOR COUNSELORS, THERAPISTS, & PSYCHO-EDUCATIONAL SPECIALISTS" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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