Individual
JACQUELINE HANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S, LMFT
Contact information
Practice address
125 ALPINE CIR, COLUMBIA, SC 29223-6385
(803) 779-3548
(803) 799-7055
Mailing address
219 WHITBY RD, IRMO, SC 29063-2435
(803) 338-5059
(803) 638-4890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6984
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
6984
SC
101YP2500X
Professional Counselor
Primary
6984
SC
Other
Enumeration date
11/12/2017
Last updated
06/03/2019
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