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Individual

JENNIFER SHACKELFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, CAC II

Contact information

Practice address
121 WOODGLEN LN, CHAPIN, SC 29036-7513
(803) 407-0819
(803) 407-0819
Mailing address
121 WOODGLEN LN, CHAPIN, SC 29036-7513
(803) 407-0819
(803) 407-0819

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1112215
SC
101YP2500X
Professional Counselor
Primary
2195
SC

Other

Enumeration date
08/04/2013
Last updated
08/04/2013
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