Healthcare Provider Details

I. General information

NPI: 1669424818
Provider Name (Legal Business Name): KERSHAW COUNTY COMMISSION ON ALCOHOL AND DRUG ABUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 KING ST
CAMDEN SC
29020-4720
US

IV. Provider business mailing address

208 KING ST
CAMDEN SC
29020-4720
US

V. Phone/Fax

Practice location:
  • Phone: 803-432-6902
  • Fax: 803-425-0923
Mailing address:
  • Phone: 803-432-6902
  • Fax: 803-425-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARA HORTON JONES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 803-432-6902