Healthcare Provider Details

I. General information

NPI: 1164000873
Provider Name (Legal Business Name): JESSIKA PIGNONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 SAVAGE RD STE 100E
CHARLESTON SC
29407-4788
US

IV. Provider business mailing address

173 RIVER BREEZE DR
CHARLESTON SC
29407-5689
US

V. Phone/Fax

Practice location:
  • Phone: 843-920-0570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-71256
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: