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NPI Code Detail

MEDICARE: JANE T CLEMMER LMSW

MEDICARE: JANE T CLEMMER LMSW
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
1104100000XSocial Worker6547SC

General Provider Information

NPI Number : 1952455222
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE T CLEMMER LMSW
Provider Business Mailing Address
First Line : PO BOX 1869
Second Line :
City : SPARTANBURG
State : SC
Zip : 29304-1869
Country : US
Telephone Number : 864-585-0366
Fax Number : 864-585-9208
Provider Business Practice Location Address
First Line : 325 S CHURCH ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29306-5231
Country : US
Telephone Number : 864-582-5431
Fax Number : 864-582-7111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 12/09/2016

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