Provider Demographics
NPI:1992593784
Name:MICHAELS, JENNIFER (PRE-LCP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MICHAELS
Suffix:
Gender:
Credentials:PRE-LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 BELLE ISLE AVE
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8262
Mailing Address - Country:US
Mailing Address - Phone:843-514-2848
Mailing Address - Fax:
Practice Address - Street 1:207 SIMMONS ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4347
Practice Address - Country:US
Practice Address - Phone:843-514-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health