JLS PHD LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JLS PHD LLC

Practice address

308 Bermuda Towne Row
Mount Pleasant, SC 29464-8230

Phone

(203) 518-1667

NPI assigned

Jan 19, 2021

Organization subpart

No

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

Authorized official

Name

Jaclyn SousaNPI 1396197356

Title

Clinical Psychologist

Phone

(203) 518-1667

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.

• Jaclyn Sousa, PH.D.

  • Clinical Psychologist
  • Mount Pleasant, SC
  • NPI 1396197356
  NPD Authorized official

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1770173361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 BERMUDA TOWNE ROW",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 BERMUDA TOWNE ROW",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648230",
            "telephone_number": "203-518-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLS PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "SOUSA",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "203-518-1667"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tanya Lynn Jingst, LISW-CP
• John P Bolger PHD LLC
• Tara M Johnson Hughes, P.A.
• Alan Haynes Johnson, PH.D.
• Carl R Johnson
• Donald R Johnson II, M.D.

• Community/Behavioral Health Agency in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Community/Behavioral Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.