NPI 1063118701 · live from the CMS NPI Registry
Jacqueline Marie Addis
Counselor, Mental Health in Greenville, SC. National Provider Identifier 1063118701, active.
NPI record
| NPI | 1063118701 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 124 Mallard St, Greenville, SC 29601 |
| Practice phone | 864-241-1040 |
| Enumerated | February 3, 2023 |
| Last updated | February 3, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.