Healthcare Provider Details

I. General information

NPI: 1255686051
Provider Name (Legal Business Name): WOODBRIDGE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 FAIRWAY LAKES RD
GREENWOOD SC
29649-8437
US

IV. Provider business mailing address

715 FAIRWAY LAKES RD
GREENWOOD SC
29649-8437
US

V. Phone/Fax

Practice location:
  • Phone: 814-759-4344
  • Fax: 866-986-2743
Mailing address:
  • Phone: 814-759-4344
  • Fax: 866-986-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005764
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS005187L
License Number StatePA

VIII. Authorized Official

Name: JENNIFER LLOYD
Title or Position: OWNER
Credential:
Phone: 814-759-4344