Healthcare Provider Details

I. General information

NPI: 1063107142
Provider Name (Legal Business Name): LORIN JETT LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 06/24/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 BELLEVIEW ST STE 101
COLUMBIA SC
29201-1868
US

IV. Provider business mailing address

1105 BELLEVIEW ST STE 103
COLUMBIA SC
29201-1839
US

V. Phone/Fax

Practice location:
  • Phone: 803-318-9826
  • Fax:
Mailing address:
  • Phone: 803-401-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8274
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10416
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: