Provider Demographics
NPI:1861204778
Name:MYRTLE BEACH INTEGRATED THERAPIES PLLC
Entity type:Organization
Organization Name:MYRTLE BEACH INTEGRATED THERAPIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:N
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:720-371-6569
Mailing Address - Street 1:1293 PROFESSIONAL DR STE D216
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5754
Mailing Address - Country:US
Mailing Address - Phone:848-200-2086
Mailing Address - Fax:
Practice Address - Street 1:1293 PROFESSIONAL DR STE D216
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5754
Practice Address - Country:US
Practice Address - Phone:848-200-2086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty