Basic Information
Provider Information
NPI: 1669786364
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEDDINGS
FirstName: CHERYL
MiddleName: S
NamePrefix: MRS.
NameSuffix:  
Credential: LISW-CP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHUMPERT
OtherFirstName: CHERYL
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LMSW
OtherLastNameType: 1
Mailing Information
Address1: 6439 GARNERS FERRY RD
Address2: SOCIAL WORK SERVICE
City: COLUMBIA
State: SC
PostalCode: 292091638
CountryCode: US
TelephoneNumber: 8037764000
FaxNumber:  
Practice Location
Address1: 6439 GARNERS FERRY RD
Address2: SOCIAL WORK SERVICE
City: COLUMBIA
State: SC
PostalCode: 292091638
CountryCode: US
TelephoneNumber: 8037764000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2010
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X7008SCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home