Healthcare Provider Details

I. General information

NPI: 1861396533
Provider Name (Legal Business Name): JENNIE CUSHMAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LAVINIA AVE
GREENVILLE SC
29601-2224
US

IV. Provider business mailing address

4 WINDJAMMER LN
GREENVILLE SC
29617-7235
US

V. Phone/Fax

Practice location:
  • Phone: 864-326-5468
  • Fax:
Mailing address:
  • Phone: 864-270-1675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER PARISOT CUSHMAN
Title or Position: OWNER
Credential: LPC
Phone: 864-270-1675