Healthcare Provider Details

I. General information

NPI: 1598146037
Provider Name (Legal Business Name): JACQULINE MARISA FILBECK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2015
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 TOBIAS GADSON BLVD STE 107
CHARLESTON SC
29407-4795
US

IV. Provider business mailing address

1065 NE 125TH ST STE 409
NORTH MIAMI FL
33161-5834
US

V. Phone/Fax

Practice location:
  • Phone: 888-852-6672
  • Fax: 843-766-8606
Mailing address:
  • Phone: 888-852-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10193
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10193
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: