Jordan, Millicent Clemons

Jordan, Millicent Clemons is an sole proprietor health care provider with primary practice located at 1 Carriage Ln Bldg J, Charleston SC 29407-6060. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Jordan, Millicent Clemons can be contacted via phone (843) 573-5050.

Contact Information

Primary practice address
1 Carriage Ln Bldg J Charleston SC 29407-6060
Phone: (843) 573-5050
Fax: (843) 573-5030
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2623 South Carolina

Profile Details

NPI number 1235194218
LBN Legal business name Jordan, Millicent Clemons
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 20th, 2006
Last updated Jul 31st, 2008 - about 16 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 1235194218 NPPES
South Carolina Other 202569 MEDICAID HO

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