Provider Demographics
NPI:1306392139
Name:PRINGLE, JENNIFER L (LCMHC LCAS LPC CMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:PRINGLE
Suffix:
Gender:F
Credentials:LCMHC LCAS LPC CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 PALMETTO POINTE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-1202
Mailing Address - Country:US
Mailing Address - Phone:843-252-0323
Mailing Address - Fax:910-364-9966
Practice Address - Street 1:3691 PALMETTO POINTE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-1202
Practice Address - Country:US
Practice Address - Phone:843-252-0323
Practice Address - Fax:910-364-9966
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS 23085101YA0400X
SC7246101YP2500X
NC12850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)