MEDICARE: GEORGE F WEBB LISW-CP

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	8486	SC

General Provider Information

NPI Number	:	1588844500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE F WEBB LISW-CP

Provider Business Mailing Address
First Line	:	1 CARRIAGE LN
Second Line	:	BLD J
City	:	CHARLESTON
State	:	SC
Zip	:	29407-6060
Country	:	US
Telephone Number	:	843-513-4330
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CARRIAGE LN
Second Line	:	BLD J
City	:	CHARLESTON
State	:	SC
Zip	:	29407-6060
Country	:	US
Telephone Number	:	843-513-4330
Fax Number	:

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

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	01/12/2010

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