MEDICARE: ABBYE PRICE 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
1	1041C0700X	Clinical Social Worker	10828	SC

General Provider Information

NPI Number	:	1912569435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBYE PRICE LISW-CP

Provider Business Mailing Address
First Line	:	2645A HARDEE CV
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-1893
Country	:	US
Telephone Number	:	803-720-9465
Fax Number	:	803-526-7067

Provider Business Practice Location Address
First Line	:	2645A HARDEE CV
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-1893
Country	:	US
Telephone Number	:	803-720-9465
Fax Number	:	803-526-7067

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

Provider Enumeration Date	:	07/04/2019
Last Update Date	:	07/04/2019

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Directions to “ ABBYE PRICE LISW-CP” Practice Location

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