Anderson, Jill M
Anderson, Jill M is an sole proprietor health care provider with primary practice located at 215 Ronnie Ct Ste D-1 , Myrtle Beach SC 29579-4204. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Anderson, Jill M can be contacted via phone (704) 223-0623.Contact Information
Primary practice address
215 Ronnie Ct Ste D-1
Myrtle Beach SC 29579-4204
Phone: (704) 223-0623
Fax: (843) 432-3091
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 8077 | North Carolina |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 6063 | South Carolina |
Profile Details
| NPI number | 1487989745 |
|---|---|
| LBN Legal business name | Anderson, Jill M |
| Credentials | MA, LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 5th, 2009 |
| Last updated | Jul 21st, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487989745 | NPPES |
| South Carolina | MEDICAID | PC1812 |
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