Healthcare Provider Details

I. General information

NPI: 1932567195
Provider Name (Legal Business Name): JSS BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 RIVERS AVE SUITE 100
N CHARLESTON SC
29406-4650
US

IV. Provider business mailing address

7301 RIVERS AVE SUITE 100
N CHARLESTON SC
29406-4650
US

V. Phone/Fax

Practice location:
  • Phone: 843-637-4211
  • Fax: 843-793-3691
Mailing address:
  • Phone: 843-637-4211
  • Fax: 843-793-3691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY S SELMAN
Title or Position: DIRECTOR
Credential: PSYD
Phone: 843-637-4211