Individual
JENNIFER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4410
Mailing address
5944 WILLARD DR, HANAHAN, SC 29410-2626
(412) 508-5271
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9256
SC
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
06/01/2015
Last updated
11/02/2023
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