Healthcare Provider Details

I. General information

NPI: 1932025038
Provider Name (Legal Business Name): JASMINE BISSELL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LINWA BLVD
ANDERSON SC
29621-4486
US

IV. Provider business mailing address

1 LINWA BLVD
ANDERSON SC
29621-4486
US

V. Phone/Fax

Practice location:
  • Phone: 864-260-2220
  • Fax:
Mailing address:
  • Phone: 864-260-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number18779
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: