Healthcare Provider Details

I. General information

NPI: 1497816029
Provider Name (Legal Business Name): KATHRYN LINDSEY GROGAN LISW-CP-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN LINDSEY ROSINSKI LMSW

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PALMETTO PARK BLVD
LEXINGTON SC
29072-7872
US

IV. Provider business mailing address

1633 S LAKE DR
LEXINGTON SC
29073-7755
US

V. Phone/Fax

Practice location:
  • Phone: 803-359-7206
  • Fax:
Mailing address:
  • Phone: 803-520-8295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7379
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: