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Individual

MS. JAN DENEAN BANISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LPC/S

Contact information

Practice address
716 ANDERSON STREET SUITE B, BELTON, SC 29627-2148
(864) 933-0793
(800) 340-0223
Mailing address
716 ANDERSON STREET SUITE B, BELTON, SC 29627-2148
(864) 933-0793
(800) 340-0223

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC3524
SC
101YM0800X
Mental Health Counselor
Primary
3524
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PC1336
SC
Enumeration date
12/20/2006
Last updated
09/10/2019
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