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General NPI Number Information
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NPI Number | 1629934534
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Entity Type | Organization
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Legal Business Name | JUSIAH PROWELL LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 201 ROCKY SLOPE RD APT 409
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City | GREENVILLE
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State | SC
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Zip | 29607-3949
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Country | US
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Telephone | 864-334-8251
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16101
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City | GREENVILLE
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State | SC
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Zip | 29606-7101
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Country | US
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Telephone | 864-334-8251
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSIAH PROWELL
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Credential | PH.D.; LP
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Telephone | 864-334-8251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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