Healthcare Provider Details

I. General information

NPI: 1063336493
Provider Name (Legal Business Name): KAROLINA W DEMACIEJOWSKA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 DOCTOR CIR
COLUMBIA SC
29203-6502
US

IV. Provider business mailing address

4202 VISTA WOOD DR
MYRTLE BEACH SC
29579-4313
US

V. Phone/Fax

Practice location:
  • Phone: 978-380-8055
  • Fax:
Mailing address:
  • Phone: 978-380-8055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13477
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: