Individual
CANDACE J JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
121 EXECUTIVE CENTER DR STE 102, COLUMBIA, SC 29210-8418
(843) 894-0000
(843) 589-9054
Mailing address
PO BOX 16091, SURFSIDE BEACH, SC 29587-6091
(843) 894-0000
(843) 589-9054
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9986
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190166
—
SC
Enumeration date
11/01/2006
Last updated
07/26/2024
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