| Jessica Green, LPC | |
|
1268 S 4th St, Hartsville, SC 29550-0703 | |
| (843) 332-3422 | |
| (843) 332-3985 |
| Full Name | Jessica Green |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 1268 S 4th St, Hartsville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104221811 | NPI | - | NPPES |
| PC1862 | Medicaid | SC | |
| SCS668 | Other | SC | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6910 (South Carolina) | Primary |
| Entity Name | Caresouth Carolina Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Green, LPC Po Box 1090, Hartsville, SC 29551-1090 Ph: (843) 857-0111 | Jessica Green, LPC 1268 S 4th St, Hartsville, SC 29550-0703 Ph: (843) 332-3422 |
Eric Radcliff, Counselor Medicare: Not Enrolled in Medicare Practice Location: 501 E. Carolina Ave., Hartsville, SC 29550 Phone: 843-332-4156 | |
Taylor Pederson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 S 4th St, Hartsville, SC 29550 Phone: 843-332-4141 | |
Audrey Pinckney, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1451 Retail Row, Hartsville, SC 29550 Phone: 877-848-9810 | |
Mr. Thomas Blackmon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 217 E Carolina Ave, Hartsville, SC 29550 Phone: 843-332-4141 | |
Mr. Lentheus Mcalister, Counselor Medicare: Not Enrolled in Medicare Practice Location: 217 E Carolina Ave, Hartsville, SC 29550 Phone: 843-332-4141 | |
Angela Wellman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 149 E Carolina Ave, Hartsville, SC 29550 Phone: 843-857-0074 Fax: 843-857-0081 | |
Brittany Cranford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1451 Retail Row, Hartsville, SC 29550 Phone: 843-383-4848 Fax: 843-383-4828 |