Healthcare Provider Details

I. General information

NPI: 1528609724
Provider Name (Legal Business Name): MARINA WESTPHAL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARINA HINOJOS

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 TOBIAS GADSON BLVD
CHARLESTON SC
29407-8702
US

IV. Provider business mailing address

854 BIBURY CT
CHARLESTON SC
29414-9120
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-5026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-17715
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW16363CP
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904019583
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: