Provider Demographics
NPI:1891070108
Name:NUNNELLEY, JEREMY (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:NUNNELLEY
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-4038
Mailing Address - Country:US
Mailing Address - Phone:706-489-0899
Mailing Address - Fax:
Practice Address - Street 1:815 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-4038
Practice Address - Country:US
Practice Address - Phone:706-489-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20804101YM0800X
GALPC010624101YP2500X
SC5317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health