Jerido-Fair Counseling Services

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6284 Issued in SC

Legal business name

JERIDO-FAIR COUNSELING SERVICES

Practice address

608 King St
Walterboro, SC 29488-5330

Phone

(843) 635-0149

NPI assigned

Jun 14, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly Davis

Title

Credentialing Specialists

Phone

(912) 484-3879

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1003266784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 KING ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885330",
            "telephone_number": "843-635-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 KING ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885330",
            "telephone_number": "843-635-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERIDO-FAIR COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALISTS",
        "authorized_official_telephone_number": "912-484-3879"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Clegg Jacobs
• Beatrice Renee Jamison, LMSW
• Tim Jamison
• Kellie Jellyman
• Jaleel Devann Jennings, PHARMD
• Leo J Jesion, D.O.
• Kristina W Johnson, RN
• Tamela Johnson, ADC-IP
• John Johnston, M.D.
• Kelly Amanda Jones, PHARMD

• Mental Health Counselor in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.