Healthcare Provider Details

I. General information

NPI: 1851417711
Provider Name (Legal Business Name): DONNA DAVIS JONES M. ED., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 LEAPHART RD
WEST COLUMBIA SC
29169-3000
US

IV. Provider business mailing address

3050 LEAPHART RD
WEST COLUMBIA SC
29169-3000
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-0495
  • Fax: 803-791-1958
Mailing address:
  • Phone: 803-791-0495
  • Fax: 803-791-1958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2754
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: