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NPI Code Detail

MEDICARE: MRS. MAUREEN LYNNE RADOSTI LMSW, MSW, MBA

MEDICARE: MRS. MAUREEN LYNNE RADOSTI LMSW, MSW, MBA
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 WorkerSC

General Provider Information

NPI Number : 1699630319
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MAUREEN LYNNE RADOSTI LMSW, MSW, MBA
Provider Business Mailing Address
First Line : 3400 PICKET FENCE LN
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-3323
Country : US
Telephone Number : 843-945-1452
Fax Number : 843-945-1489
Provider Business Practice Location Address
First Line : 630 CHESTNUT RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29572-5502
Country : US
Telephone Number : 843-945-1452
Fax Number : 843-945-1489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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