Organization
TRUE LIGHT COUNSELING AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRONDA LANAE' JACKSON MA, LPCA (PSYCHOTHERAPIST)
(803) 814-7115
Entity
Organization
Contact information
Practice address
140 HUNTERS RUN DR, BLYTHEWOOD, SC 29016-9206
(302) 265-5993
Mailing address
140 HUNTERS RUN DR, BLYTHEWOOD, SC 29016-9206
(302) 265-5993
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045081474
TRICARE PRIME
—
01
—
6574
LPCA
SC
Enumeration date
01/14/2019
Last updated
01/14/2019
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