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General NPI Number Information
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NPI Number | 1639850654
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Entity Type | Individual
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Provider Name | RICKIA JESSUP-CLOWNEY
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Gender | Female
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 101 N PINE ST STE 210
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City | SPARTANBURG
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State | SC
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Zip | 29302-1604
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Country | US
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Telephone | 864-529-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W CHURCH ST
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City | SALUDA
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State | SC
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Zip | 29138-7343
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Country | US
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Telephone | 864-901-8845
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Fax | 864-406-6042
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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 | 8367
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License Number State | SC
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