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NPI Code Detail

MEDICARE: MS. ELIZABETH HOLMES EVERETT LISW-CP

MEDICARE:  MS. ELIZABETH HOLMES EVERETT  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 WorkerC006113NC
21041C0700XClinical Social Worker6413SC

General Provider Information

NPI Number : 1699925875
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH HOLMES EVERETT LISW-CP
Provider Business Mailing Address
First Line : 215 RONNIE CT STE C
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-4204
Country : US
Telephone Number : 843-894-0000
Fax Number : 843-589-9054
Provider Business Practice Location Address
First Line : 215 RONNIE CT
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-4204
Country : US
Telephone Number : 843-894-0000
Fax Number : 843-589-9054
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2008
Last Update Date : 09/27/2023

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Directions to “ MS. ELIZABETH HOLMES EVERETT LISW-CP” Practice Location

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