Healthcare Provider Details

I. General information

NPI: 1609669548
Provider Name (Legal Business Name): JENNIFER DUNLAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 CLEMENTS FERRY RD STE 207C
CHARLESTON SC
29492-8657
US

IV. Provider business mailing address

219 SAWYER CIR UNIT 833
CHARLESTON SC
29492-8645
US

V. Phone/Fax

Practice location:
  • Phone: 843-352-3424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10411
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: