Individual
JILL M ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
215 RONNIE CT STE D-1, MYRTLE BEACH, SC 29579-4204
(704) 223-0623
(843) 432-3091
Mailing address
673 CHERRY BLOSSOM DR, MURRELLS INLET, SC 29576-9372
(704) 223-0623
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6063
SC
101YM0800X
Mental Health Counselor
8077
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1812
—
SC
Enumeration date
10/05/2009
Last updated
07/21/2022
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