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Contact Information

JESSICA PENA, PH.D. M.S. MED LPCS
414 LAURENS ST
CAMDEN, SC29020-3607
 Phone: 803-369-4170
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Professional

101YP2500X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JESSICA PENA · (Female)

NPI Number 1578807749
Status Active
Credentials PH.D. M.S. MED LPCS
Entity Individual
Enumeration date 11/12/2012
Last updated 10/16/2025 - About 8 months ago
Sole proprietor 1 Yes
Identifiers
  • SC License # 5726
  • SC Medicaid PS1420
  • SC Other 5723 LP
  • SC Other 5726 SC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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