Healthcare Provider Details

I. General information

NPI: 1992036115
Provider Name (Legal Business Name): STACI L ALUMBAUGH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACI SWIFT LCSW

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 10/26/2024
Certification Date: 10/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 CAROLINA EXCHANGE DR
MYRTLE BEACH SC
29579-4220
US

IV. Provider business mailing address

PO BOX 547
LITTLE RIVER SC
29566-0547
US

V. Phone/Fax

Practice location:
  • Phone: 843-663-8000
  • Fax: 843-663-8166
Mailing address:
  • Phone: 843-663-8294
  • Fax: 843-663-8166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16880
License Number StateSC

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: