MEDICARE: PRACTICAL SOLUTIONS FOR EVERYDAY LIVING, INC.

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	4770	SC

General Provider Information

NPI Number	:	1811165442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRACTICAL SOLUTIONS FOR EVERYDAY LIVING, INC.

Provider Business Mailing Address
First Line	:	103 RIVER BREEZE DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5662
Country	:	US
Telephone Number	:	843-814-9707
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 RIVER BREEZE DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5662
Country	:	US
Telephone Number	:	843-814-9707
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MS. GAIL NINA MATTIX
Credential	:	LISW-CP
Telephone Number	:	843-814-9707

Provider Enumeration Date	:	02/18/2008
Last Update Date	:	06/29/2009

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