Healthcare Provider Details

I. General information

NPI: 1851586796
Provider Name (Legal Business Name): CHRISTIE MAE HITE LCSW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTIE MAE TRICK

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 EDGEFIELD ST
GREENWOOD SC
29646-3205
US

IV. Provider business mailing address

1033 EDGEFIELD ST
GREENWOOD SC
29646-3205
US

V. Phone/Fax

Practice location:
  • Phone: 864-227-3908
  • Fax: 864-227-2668
Mailing address:
  • Phone: 864-227-3908
  • Fax: 864-227-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number13306
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13306
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: