MEDICARE: JOYECE ANDERSON ABD, MSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	9372	SC

General Provider Information

NPI Number	:	1518398015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYECE ANDERSON ABD, MSW, LMSW

Provider Business Mailing Address
First Line	:	120 AMELIA FOREST LN
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29209-1759
Country	:	US
Telephone Number	:	330-518-2343
Fax Number	:	803-777-3498

Provider Business Practice Location Address
First Line	:	1417 GREGG ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3527
Country	:	US
Telephone Number	:	803-758-2445
Fax Number	:	803-758-2445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2013
Last Update Date	:	12/09/2013

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