Mack, Jacqueline
Mack, Jacqueline is an individual health care provider with primary practice located at 215 Commerce St , Manning SC 29102-2638. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Mack, Jacqueline can be contacted via phone (803) 435-2124.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | South Carolina |
Profile Details
| NPI number | 1114046687 |
|---|---|
| LBN Legal business name | Mack, Jacqueline |
| Credentials | M.H.P, M.A. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Aug 21st, 2007 - about 17 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 | 1114046687 | NPPES |
| South Carolina | MEDICAID | 376241 |
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