MEDICARE: JENNIFER F ELKINS EDD LPC LPCS RPTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	4156	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003875519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER F ELKINS EDD LPC LPCS RPTS

Provider Business Mailing Address
First Line	:	887 NE MAIN ST STE C
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2041
Country	:	US
Telephone Number	:	843-615-2770
Fax Number	:	864-228-7247

Provider Business Practice Location Address
First Line	:	887 NE MAIN ST STE C
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-2041
Country	:	US
Telephone Number	:	864-538-6906
Fax Number	:	864-479-4141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	03/03/2025

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