Organization
988 SOUTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE SHERIDAN (MENTAL HEALTH PROFESSIONAL)
(262) 865-8357
Entity
Organization
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
Mailing address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
05/30/2024
Last updated
05/30/2024
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