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General NPI Number Information
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NPI Number | 1215268008
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Entity Type | Individual
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Provider Name | COURTNEY LYNN HOWARD LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 110 HOSPITAL DR STE B
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-3226
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Country | US
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Telephone | 864-663-2664
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Fax | 864-688-2766
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Provider Business Mailing Address
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Address Line | 409 TEA OLIVE PL
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-8105
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Country | US
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Telephone | 864-663-2664
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Fax | 864-688-2766
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10093
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License Number State | SC
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