Jackson, Terronda Lanae
Jackson, Terronda Lanae is an sole proprietor health care provider with primary practice located at 140 Hunters Run Dr , Blythewood SC 29016-9206. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional, Agencies / Community/Behavioral Health, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Jackson, Terronda Lanae can be contacted via phone (803) 814-7115.Contact Information
Primary practice address
140 Hunters Run Dr
Blythewood SC 29016-9206
Phone: (803) 814-7115
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 6574 | South Carolina |
| Behavioral Health & Social Service Providers / Pastoral | 101YP1600X | 6574 | South Carolina |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6574 | South Carolina |
| Agencies / Community/Behavioral Health | 251S00000X | 6574 | South Carolina |
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 6574 | South Carolina |
Profile Details
| NPI number | 1992276810 |
|---|---|
| LBN Legal business name | Jackson, Terronda Lanae |
| Credentials | MA, LPCA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 17th, 2018 |
| Last updated | Dec 17th, 2018 - about 6 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 | 1992276810 | NPPES |
| South Carolina | Other | 6574 | LPCA |
| South Carolina | Other | 1045081474 | LPCA |
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