Jessica the Counselor, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

JESSICA THE COUNSELOR, LLC

Practice address

591 Gas Plant Rd
Moore, SC 29369-9424

Phone

(602) 354-1562

NPI assigned

Jun 26, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Jessica Ilo Clark, LPCNPI 1902385875

Title

Owner

Phone

(602) 354-1562

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Ilo Clark, LPC, NCC

  • Professional Counselor
  • Simpsonville, SC
  • NPI 1902385875
  NPD Authorized official

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1457037152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 GAS PLANT RD",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293699424",
            "telephone_number": "602-354-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 GAS PLANT RD",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293699424",
            "telephone_number": "602-354-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA THE COUNSELOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ILO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-354-1562",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Moore, SC
• Providers in Moore, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.