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General NPI Number Information
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NPI Number | 1821163288
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Entity Type | Organization
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Legal Business Name | WEINBAUM CLINICAL SERVICES
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 604 S COIT ST
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City | FLORENCE
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State | SC
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Zip | 29501-5223
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Country | US
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Telephone | 843-629-0034
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Fax | 843-629-9192
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Provider Business Mailing Address
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Address Line | 604 S COIT ST
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City | FLORENCE
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State | SC
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Zip | 29501-5223
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Country | US
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Telephone | 843-629-0034
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Fax | 843-629-9192
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA WEINBAUM
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Credential | ACSW
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Telephone | 843-629-0034
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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 | 6951
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License Number State | SC
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