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General NPI Number Information
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NPI Number | 1225524721
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Entity Type | Individual
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Provider Name | JESSICA MOGER LAWLER MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/08/2018
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 3800 FOREST DR STE A204
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City | COLUMBIA
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State | SC
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Zip | 29204-4146
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Country | US
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Telephone | 803-216-1645
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Fax |
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Provider Business Mailing Address
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Address Line | 10 DOVE FIELD CT
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City | HOPKINS
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State | SC
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Zip | 29061-9240
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Country | US
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Telephone | 507-676-5636
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3098
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4685
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License Number State | SC
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