Provider Demographics
NPI:1962564997
Name:MCMEEKIN, JANICE G (EDS)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:G
Last Name:MCMEEKIN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RICHLAND MEDICAL PARK DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6859
Mailing Address - Country:US
Mailing Address - Phone:803-434-2767
Mailing Address - Fax:803-434-2850
Practice Address - Street 1:9 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:SUITE 440
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6859
Practice Address - Country:US
Practice Address - Phone:803-434-2767
Practice Address - Fax:803-434-2850
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3802101YP2500X
SC3803106H00000X
SC4967101YP2500X
SC4503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4503OtherLICENSE MARRIAGE AND FAMILY THERAPIST SUPERVISOR
SC4967OtherLICENSE PROFESSIONAL COUNSELOR SUPERVISOR
SC3803OtherLICENSE MARRIAGE AND FAMILY THERAPIST