Healthcare Provider Details

I. General information

NPI: 1932159720
Provider Name (Legal Business Name): MS. JACQUELINE C. SESSION
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SWCMHC/CAROLINA PLACE, 525 NORTH LAFAYETTE DR.
SUMTER SC
29151-1946
US

IV. Provider business mailing address

SWCMHC, 215 N. MAGNOLIA ST.
SUMTER SC
29151-1946
US

V. Phone/Fax

Practice location:
  • Phone: 803-775-6293
  • Fax: 803-775-7593
Mailing address:
  • Phone: 803-775-9364
  • Fax: 803-773-6615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: