Provider Demographics
NPI:1366995912
Name:JEMSEK, JACQUELINE JOANNE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JOANNE
Last Name:JEMSEK
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 262
Mailing Address - Street 2:
Mailing Address - City:SULLIVANS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29482-0262
Mailing Address - Country:US
Mailing Address - Phone:843-810-4800
Mailing Address - Fax:
Practice Address - Street 1:745 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3071
Practice Address - Country:US
Practice Address - Phone:843-810-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5705101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor