Doctor Name: | MR. JASON FRANKLIN CLEMONS |
NPI Number: | 1225257298 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 4804 |
Business Practice Address: | 12117 Ocean Hwy Pawleys Island, SC - 295857941 |
Business Phone Number: | 8435451271 |
Business Fax Number: | 8432378551 |
Mailing Address: | Po Box 4325, PAWLEYS ISLAND |
State: | SC |
Postal Code: | 295858325 |
Phone Number: | 8435451271 |
Fax Number: | 8432378551 |
NPI Enumeration Date: | 04/25/2007 |
NPI Last Update Date: | 09/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4804 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |