Individual provider Active NPI

Jean Summerrow, LPC

  • Professional Counselor
  • Spartanburg, SC
National Provider Identifier
1619331865
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3530 Issued in SC
Practice address
250 Dewey Ave
Spartanburg, SC 29303-3009
Phone
(864) 585-0366
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3530 SC Primary

Addresses

Primary practice location

250 Dewey Ave
Spartanburg, SC 29303-3009

Mailing address

250 Dewey Ave
Spartanburg, SC 29303-3009
Phone (864) 585-0366

Other practice location 1

939 Springdale Dr
Clinton, SC 29325-7266
Phone (910) 742-9243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240822003105 SC Practitioner - Mental Health Counselor 4587103569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2315 Davenport CT
Moore, SC 29369-8707

250 Dewey Ave
Spartanburg, SC 29303-3009

PO Box
Atlanta, GA 30353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3530SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince Nov 1, 2025 Accepting new patients
Lifesource of North Carolina CurrentSince Nov 1, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince May 30, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince May 30, 2024 Accepting new patients

Locations

125 E Robinson St
Gaffney, SC 29340
Phone (864) 487-2710

1915 Ebenezer Rd
Rock Hill, SC 29732
Phone (305) 866-9951

250 Dewey Ave
Spartanburg, SC 29303
Phone (864) 585-0366

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1619331865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DEWEY AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033009",
            "telephone_number": "864-585-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DEWEY AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033009",
            "telephone_number": "864-585-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 Springdale Dr",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "SC",
            "postal_code": "293257266",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERROW",
        "first_name": "JEAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "3530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.