Fortune, Jane Medlin

Fortune, Jane Medlin is an individual health care provider with primary practice located at 4999 Carolina Forest Blvd Suite 22, Myrtle Beach SC 29579-3587. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Fortune, Jane Medlin can be contacted via phone (843) 506-0462.

Contact Information

Primary practice address
4999 Carolina Forest Blvd Suite 22 Myrtle Beach SC 29579-3587
Phone: (843) 506-0462
Fax: (888) 727-1946
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 4937 South Carolina

Profile Details

NPI number 1689859100
LBN Legal business name Fortune, Jane Medlin
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2008
Last updated Mar 27th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689859100 NPPES
South Carolina MEDICAID PC1051

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