Jill M Anderson, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6063 Issued in SC

Practice address

215 Ronnie CT Ste D-1
Myrtle Beach, SC 29579-4204

Phone

(704) 223-0623

Fax

(843) 432-3091

NPI assigned

Oct 5, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Haven Counseling LLC

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1609314293

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487989745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 CHERRY BLOSSOM DR",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769372",
            "telephone_number": "704-223-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 RONNIE CT STE D-1",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794204",
            "telephone_number": "704-223-0623",
            "fax_number": "843-432-3091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "673 Cherry Blossom Dr",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295769372",
            "country_code": "US",
            "telephone_number": "704-223-0623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Waccamaw Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268903",
            "country_code": "US",
            "telephone_number": "704-223-0623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8077",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1812",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anchor of Hope Counseling Services LLC
• Anchorpoint Psychiatry & Wellness
• Jason M Anders, DPT
• Samuel Nels Andersen, MD
• Alicia Williams Anderson, FNP
• Ava Andrews, RPH
• Stephen Francis Andrews, DO
• Anesthesia SC LLC
• Alexander Anetakis
• Angel Oak Nursing and Rehabilitation Center LLC

• All providers in Myrtle Beach, SC
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.