Self, Jennifer

Self, Jennifer is an individual health care provider with primary practice located at 1035 Cheraw St. , Bennettsville SC 29512. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Self, Jennifer can be contacted via phone (843) 454-0442.

Contact Information

Primary practice address
1035 Cheraw St. Bennettsville SC 29512
Phone: (843) 454-0442
Fax: (843) 454-0212
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1366525362
LBN Legal business name Self, Jennifer
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Mar 7th, 2012 - about 14 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 1366525362 NPPES
South Carolina MEDICAID 405127

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