Healthcare Provider Details

I. General information

NPI: 1407787146
Provider Name (Legal Business Name): MARY DEANE ROBBINS LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 FOREST DR STE 302
COLUMBIA SC
29204-4057
US

IV. Provider business mailing address

709 GRANBY XING
CAYCE SC
29033-4352
US

V. Phone/Fax

Practice location:
  • Phone: 803-699-8887
  • Fax:
Mailing address:
  • Phone: 843-714-4551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18784
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: