MEDICARE: BRIAN RAMICH LISW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1144607524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN RAMICH LISW

Provider Business Mailing Address
First Line	:	1071 SEA EAGLE WATCH
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-8252
Country	:	US
Telephone Number	:	843-763-2104
Fax Number	:	843-654-4850

Provider Business Practice Location Address
First Line	:	2000 SAM RITTENBURG BLVD
Second Line	:	SUITE 2011
City	:	CHARLESTON
State	:	SC
Zip	:	29407-4631
Country	:	US
Telephone Number	:	843-763-2104
Fax Number	:	843-654-4850

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

Provider Enumeration Date	:	05/05/2015
Last Update Date	:	08/01/2024

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Directions to “ BRIAN RAMICH LISW” Practice Location

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