Organization
MINDFULCO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PENA LPC, LPCS, PSYD, PHD (OWNER)
(803) 272-8685
Entity
Organization
Contact information
Practice address
414 LAURENS ST, CAMDEN, SC 29020-3607
(803) 272-8685
(803) 962-1705
Mailing address
414 LAURENS ST, CAMDEN, SC 29020-3607
(803) 272-8685
(803) 962-1705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578807749
—
SC
Enumeration date
11/19/2025
Last updated
11/19/2025
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