Healthcare Provider Details

I. General information

NPI: 1184536336
Provider Name (Legal Business Name): DAVID CARRICO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N GUIGNARD DR
SUMTER SC
29150-4870
US

IV. Provider business mailing address

5 WINGATE CT
SUMTER SC
29154-6043
US

V. Phone/Fax

Practice location:
  • Phone: 803-840-1156
  • Fax:
Mailing address:
  • Phone: 803-847-7310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19309
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: