Individual
JEFFERY LEWIS GAYKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, CAC-I
Contact information
Practice address
719 S LAKE DR, LEXINGTON, SC 29072-3432
(803) 308-0922
Mailing address
122 ROBINSON DR, NORTH, SC 29112-8360
(803) 308-0922
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1910242
SC
101YM0800X
Mental Health Counselor
Primary
6540
SC
Other
Enumeration date
06/27/2020
Last updated
06/27/2020
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