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NPI Code Detail

MEDICARE: MRS. ANGELA MARIA GROCE LISW-CP

MEDICARE:  MRS. ANGELA MARIA GROCE  LISW-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
11041C0700XClinical Social Worker8423SC

General Provider Information

NPI Number : 1215045190
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA MARIA GROCE LISW-CP
Provider Business Mailing Address
First Line : 210 CHESTNUT WREN RD
Second Line :
City : BLYTHEWOOD
State : SC
Zip : 29016
Country : US
Telephone Number : 803-606-3685
Fax Number : 803-705-5690
Provider Business Practice Location Address
First Line : 1620 PENDLETON ST A207
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-3836
Country : US
Telephone Number : 803-705-5156
Fax Number : 803-705-5690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 07/17/2015

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Directions to “ MRS. ANGELA MARIA GROCE LISW-CP” Practice Location

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