MEDICARE: MR. WALLACE JERRY WALDROP JR. LMFT

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	106H00000X	Marriage & Family Therapist	1746	NC
2	106H00000X	Marriage & Family Therapist	6995	SC

General Provider Information

NPI Number	:	1891224283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WALLACE JERRY WALDROP JR. LMFT

Provider Business Mailing Address
First Line	:	2917 MILLWOOD AVE BLDG B
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-1334
Country	:	US
Telephone Number	:	803-814-6218
Fax Number	:	855-490-9560

Provider Business Practice Location Address
First Line	:	2917 MILLWOOD AVE BLDG B
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29205-1334
Country	:	US
Telephone Number	:	803-814-6218
Fax Number	:	855-490-9560

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

Provider Enumeration Date	:	06/08/2017
Last Update Date	:	07/21/2022

Similar Medicare Providers

1356292098 — JOHN DANIEL HUNT
Practice Location Address:

2917 MILLWOOD AVE STE B
COLUMBIA, SC
29205-1334

Practice Phone: 839-292-8357
Practice Fax:

1093958431 — MS. ANN MAC CALLOWAY PREVOST LPC
Practice Location Address:

2917 MILLWOOD AVE STE B
COLUMBIA, SC
29205-1334

Practice Phone: 803-464-7333
Practice Fax:

1558782151 — CASEY LEE
Practice Location Address:

2917 MILLWOOD AVE STE B
COLUMBIA, SC
29205-1334

Practice Phone: 803-939-5840
Practice Fax:

1609303650 — MRS. ANGELA LYNN WALDROP LMFT
Practice Location Address:

2917 MILLWOOD AVE BLDG B
COLUMBIA, SC
29205-1334

Practice Phone: 803-814-6218
Practice Fax: 855-490-9560

1235613837 — FOUNDATIONS FAMILY LIFE COUNSELING AND CONSULTING, LLC
Practice Location Address:

2917 MILLWOOD AVE # B
COLUMBIA, SC
29205-1334

Practice Phone: 803-814-6218
Practice Fax:

1982266805 — MRS. PAMELA STEELE LITCHFORD LPC
Practice Location Address:

2917 MILLWOOD AVE STE B
COLUMBIA, SC
29205-1334

Practice Phone: 803-413-2662
Practice Fax:

Directions to “ MR. WALLACE JERRY WALDROP JR. LMFT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.