Provider Demographics
NPI:1962275271
Name:ASBELL, JISELA TAURIEL
Entity type:Individual
Prefix:
First Name:JISELA
Middle Name:TAURIEL
Last Name:ASBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4597 MIXSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-5109
Mailing Address - Country:US
Mailing Address - Phone:407-487-0675
Mailing Address - Fax:
Practice Address - Street 1:2470 MALL DR UNIT CD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6514
Practice Address - Country:US
Practice Address - Phone:843-207-4721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)