MEDICARE: JASON HALLMAN 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	7345	SC

General Provider Information

NPI Number	:	1932613866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON HALLMAN LPC

Provider Business Mailing Address
First Line	:	335 PINE ST NW
Second Line	:
City	:	SALLEY
State	:	SC
Zip	:	29137-9787
Country	:	US
Telephone Number	:	803-240-6224
Fax Number	:

Provider Business Practice Location Address
First Line	:	418A BARR RD
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072-2363
Country	:	US
Telephone Number	:	803-674-4060
Fax Number	:

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

Provider Enumeration Date	:	11/30/2017
Last Update Date	:	12/11/2019

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