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NPI Code Detail

MEDICARE: MRS. JANEL A GUNTLE MA, LPC

MEDICARE: MRS. JANEL A GUNTLE MA, 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
1101YP2500XProfessional Counselor7554SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17554OTHERSCLICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number : 1568949857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANEL A GUNTLE MA, LPC
Provider Business Mailing Address
First Line : 508 BETHEL ST
Second Line :
City : CLOVER
State : SC
Zip : 29710-1154
Country : US
Telephone Number : 803-675-8227
Fax Number : 866-884-5371
Provider Business Practice Location Address
First Line : 852 GOLD HILL RD STE 204
Second Line :
City : FORT MILL
State : SC
Zip : 29708-6965
Country : US
Telephone Number : 803-228-4038
Fax Number : 866-884-5371
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2018
Last Update Date : 08/19/2020

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