Provider Demographics
NPI:1053651828
Name:HALL, JENNIFER GEDDES (PHD, LPC, ACS, RPT)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GEDDES
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD, LPC, ACS, RPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:GEDDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 N ORCHARD FARMS AVE
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4866
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 N PINE ST STE 210
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302
Practice Address - Country:US
Practice Address - Phone:864-808-0908
Practice Address - Fax:864-708-2020
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8040101YP2500X
NC9587101YM0800X
SC7293101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional