Healthcare Provider Details

I. General information

NPI: 1841671344
Provider Name (Legal Business Name): JENNIFER MARIE SHIERLOCK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 LEINBACH DR STE D2
CHARLESTON SC
29407-7086
US

IV. Provider business mailing address

29 LEINBACH DR STE D2
CHARLESTON SC
29407-7086
US

V. Phone/Fax

Practice location:
  • Phone: 843-607-4577
  • Fax: 843-242-0324
Mailing address:
  • Phone: 843-604-4577
  • Fax: 843-232-0324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number38352
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: