Jennifer D Coaxum, MA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2319 Saint Matthews Rd
Orangeburg, SC 29118-2042

Phone

(803) 536-1571

NPI assigned

Feb 20, 2025

Last updated

Feb 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

Locations

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

• Orangeburg Area Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Orangeburg, SC
  • NPI 1235999590
  NPD

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1902602931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291182042",
            "telephone_number": "803-536-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291182042",
            "telephone_number": "803-536-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAXUM",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyiesha Nicole Cleckley
• Clemson Sports Medicine and Rehabilitation (Sports Plus)
• Clemson Sports Medicine and Rehabilitation (Sports Plus)
• Clifford P Sanders
• Tyron L Clinton, MASTERS PROFESSIONAL
• Flynn Walton Cockfield Jr.
• Thomas Hamrick Coleman, MD
• Kalyn Collier, PHARMD
• Columbia Vamc
• Communication Station, LLC

• Counselor in Orangeburg, SC
• Providers in Orangeburg, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.