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NPI 1003875519

NPI 1003875519 : JENNIFER F ELKINS EDD LPC LPCS RPTS : SIMPSONVILLE, SC

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General NPI Number Information
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    NPI Number           |    1003875519
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER F ELKINS EDD LPC LPCS RPTS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/22/2006
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    Last Update Date     |    03/03/2025
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Provider Practice Location Address
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    Address Line         |    887 NE MAIN ST STE C 
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    City                 |    SIMPSONVILLE
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    State                |    SC
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    Zip                  |    29681-2041
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    Country              |    US
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    Telephone            |    864-538-6906
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    Fax                  |    864-479-4141
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Provider Business Mailing Address
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    Address Line         |    887 NE MAIN ST STE C 
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    City                 |    SIMPSONVILLE
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    State                |    SC
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    Zip                  |    29681-2041
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    Country              |    US
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    Telephone            |    843-615-2770
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    Fax                  |    864-228-7247
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    4156
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    License Number State |    SC
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