Organization
SWEETGRASS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY F JACKSON LPC (OWNER)
(843) 259-6535
Entity
Organization
Contact information
Practice address
302A MIDLAND PKWY, SUMMERVILLE, SC 29485-8102
(843) 259-6535
Mailing address
3590 MARY ADER AVE APT 1021, CHARLESTON, SC 29414-5792
(910) 712-0026
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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