Individual
JASEN CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
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
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
10/29/2013
Last updated
04/28/2023
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