Basic Information
| Provider Information | |||||||||
| NPI: | 1952455222 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLEMMER | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1869 | ||||||||
| Address2: | |||||||||
| City: | SPARTANBURG | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293041869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645850366 | ||||||||
| FaxNumber: | 8645859208 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 S CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SPARTANBURG | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293065231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645825431 | ||||||||
| FaxNumber: | 8645827111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 12/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6547 | SC | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.