MEDICARE: MS. PATRICIA ELIZABETH PLAXCO LMSW, VSW-CP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	15498	SC

General Provider Information

NPI Number	:	1013695543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ELIZABETH PLAXCO LMSW, VSW-CP

Provider Business Mailing Address
First Line	:	124 WHITE BLVD
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29483-3026
Country	:	US
Telephone Number	:	843-568-3238
Fax Number	:

Provider Business Practice Location Address
First Line	:	1435 STUART ENGALS BLVD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-7311
Country	:	US
Telephone Number	:	843-459-9805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2023
Last Update Date	:	07/05/2023

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