Healthcare Provider Details

I. General information

NPI: 1922326511
Provider Name (Legal Business Name): JENNIFER SMITH LINDLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JENNIFER ELAINE SMITH

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 LITTLE MOUNTAIN RD
NINETY SIX SC
29666-9252
US

IV. Provider business mailing address

103 LITTLE MOUNTAIN RD
NINETY SIX SC
29666-9252
US

V. Phone/Fax

Practice location:
  • Phone: 864-223-5111
  • Fax: 864-223-9245
Mailing address:
  • Phone: 864-223-5111
  • Fax: 864-223-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4005
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: