Provider Demographics
NPI:1104448158
Name:JEFFCOAT,, IRIS (MBA, LPC)
Entity type:Individual
Prefix:MS
First Name:IRIS
Middle Name:
Last Name:JEFFCOAT,
Suffix:
Gender:F
Credentials:MBA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O MS. IRIS JEFFCOAT, LPC
Mailing Address - Street 2:1320 MAIN STREET, STE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3266
Mailing Address - Country:US
Mailing Address - Phone:843-302-2944
Mailing Address - Fax:
Practice Address - Street 1:C/O MS. IRIS JEFFCOAT, LPC
Practice Address - Street 2:1320 MAIN STREET, STE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3266
Practice Address - Country:US
Practice Address - Phone:843-302-2944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6799101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional