Healthcare Provider Details

I. General information

NPI: 1669396800
Provider Name (Legal Business Name): BETH ANN MCJUNKINS MSW, LMSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 WOODLAND DR
CLOVER SC
29710-1543
US

IV. Provider business mailing address

108 WOODLAND DR
CLOVER SC
29710-1543
US

V. Phone/Fax

Practice location:
  • Phone: 864-546-0275
  • Fax:
Mailing address:
  • Phone: 864-546-0275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP020643
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: