Sydney Jennings
Individual provider Active NPI Clinical Social Worker · Lugoff, SC
NPI 1235834839 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1235834839
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 15907 (SC)
- Practice address
- 1443 Highway 1 S Ste B
Lugoff, SC 29078-9460 - Phone
- (803) 708-0902
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15907 | SC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloom Haven Therapy LLC | Clinical | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15907 | SC | Yes |
Addresses
Primary practice location
1443 Highway 1 S Ste B
Lugoff, SC 29078-9460
Mailing address
1443 Highway 1 S Ste B
Lugoff, SC 29078-9460
Phone (803) 708-0902
Other providers in Lugoff, SC
- Milford Berten Hutchinson III
- Lina Hyghes
- Invista
- Iryde Transit LLC
- Marie Jacka
- Cara Elise Jones
- Robert Kabakjian Sr.
- Min Kang
- James C Kearse III
- Crystal Keith
All providers in Lugoff, SC · Clinical Social Worker in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.