Individual
DR. JESSICA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D. M.S. MED LPCS
Contact information
Practice address
414 LAURENS ST, CAMDEN, SC 29020-3607
(803) 369-4170
Mailing address
414 LAURENS ST, CAMDEN, SC 29020-3607
(803) 369-4170
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5726
SC
103T00000X
Psychologist
5726
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5723
LP
SC
01
—
5726
SC
SC
05
—
PS1420
—
SC
Enumeration date
11/12/2012
Last updated
10/16/2025
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