Healthcare Provider Details

I. General information

NPI: 1407449713
Provider Name (Legal Business Name): SARAH HAMM SPENCER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S BROAD ST
CLINTON SC
29325-2507
US

IV. Provider business mailing address

302 S BROAD ST
CLINTON SC
29325-2507
US

V. Phone/Fax

Practice location:
  • Phone: 864-938-2100
  • Fax:
Mailing address:
  • Phone: 864-938-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW002469
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: