MEDICARE: JESSICA WOOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	10513	SC

General Provider Information

NPI Number	:	1093697435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA WOOD

Provider Business Mailing Address
First Line	:	PO BOX 5
Second Line	:
City	:	CLINTON
State	:	SC
Zip	:	29325-0005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 MAIN ST FL 18
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2435
Country	:	US
Telephone Number	:	864-923-5857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2025
Last Update Date	:	08/05/2025

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Directions to “ JESSICA WOOD ” Practice Location

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