Individual provider · Type 1 NPI

Shanta Avalice Jerideau, LPC

Mental Health Counselor · Columbia, SC

NPI number 1316290901 Active

Practice location

200 Springtree Dr Ste 200
Columbia, SC 29223-8614

Call (803) 722-4975 Map

Fax (803) 722-6018

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1316290901

Shanta Avalice Jerideau, LPC's National Provider Identifier is 1316290901, issued on Oct 19, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Columbia, SC. The record was last updated on Nov 3, 2020.