MEDICARE: MS. TRONDI JERRY LPC

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	LPC007238	GA

General Provider Information

NPI Number	:	1457766370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRONDI JERRY LPC

Provider Business Mailing Address
First Line	:	135 LOST JOHN RD
Second Line	:
City	:	HOPKINS
State	:	SC
Zip	:	29061-9543
Country	:	US
Telephone Number	:	770-841-8560
Fax Number	:

Provider Business Practice Location Address
First Line	:	5017 HOXTON TRL
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29209-5163
Country	:	US
Telephone Number	:	770-841-8560
Fax Number	:

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

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	06/02/2026

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