Healthcare Provider Details

I. General information

NPI: 1053450130
Provider Name (Legal Business Name): SANDRA H. ADAMS MSW, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 PARKWAY COMMONS WAY
GREER SC
29650-5213
US

IV. Provider business mailing address

58 PARKWAY COMMONS WAY
GREER SC
29650-5213
US

V. Phone/Fax

Practice location:
  • Phone: 864-322-7177
  • Fax: 864-271-7323
Mailing address:
  • Phone: 864-322-7177
  • Fax: 864-271-7323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLISW-CP
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. SANDRA H ADAMS
Title or Position: PRESIDENT
Credential: MSW
Phone: 864-354-1900