Provider Demographics
NPI:1801536396
Name:FILES, JACQUELYN DIANE (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:DIANE
Last Name:FILES
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PATEWOOD DR STE 160
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6809
Mailing Address - Country:US
Mailing Address - Phone:843-501-1099
Mailing Address - Fax:
Practice Address - Street 1:30 PATEWOOD DR STE 160
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6809
Practice Address - Country:US
Practice Address - Phone:843-501-1099
Practice Address - Fax:843-405-2040
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016935101YP2500X
SC8168101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional