MEDICARE: JENNIFER A ZEUSCHNER LPC

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	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	LPC.8882PCS	SC
3	101YM0800X	Mental Health Counselor	7908780-6009	UT

General Provider Information

NPI Number	:	1245530898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A ZEUSCHNER LPC

Provider Business Mailing Address
First Line	:	2411 N OAK ST STE 209F
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-3173
Country	:	US
Telephone Number	:	843-212-6995
Fax Number	:	855-318-5403

Provider Business Practice Location Address
First Line	:	2411 N OAK ST STE 209F
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-3173
Country	:	US
Telephone Number	:	843-212-6995
Fax Number	:	855-318-5403

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

Provider Enumeration Date	:	10/29/2010
Last Update Date	:	07/23/2024

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