Healthcare Provider Details

I. General information

NPI: 1730219478
Provider Name (Legal Business Name): TEMPE ANNE OEHLER, LCSW, ACSW, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 OAK STREET SUITE 107
MYRTLE BEACH SC
29577
US

IV. Provider business mailing address

PO BOX 3303
MYRTLE BEACH SC
29578-3303
US

V. Phone/Fax

Practice location:
  • Phone: 843-946-3577
  • Fax: 843-946-3507
Mailing address:
  • Phone: 843-946-3577
  • Fax: 843-946-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number000138
License Number StateSC

VII. Legacy identifiers

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

# 1
IdentifierQM0167
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name: TEMPE ANNE OEHLER
Title or Position: OWNER
Credential: LCSW, ACSW
Phone: 843-946-3577