1215255922 NPI number — MRS. LASHANDA PALMER SOCIAL WORKER

Table of content: MRS. LASHANDA PALMER SOCIAL WORKER (NPI 1215255922)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215255922 NPI number — MRS. LASHANDA PALMER SOCIAL WORKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALMER
Provider First Name:
LASHANDA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SOCIAL WORKER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIBSON-PALMER
Provider Other First Name:
LASHANDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LISW-CP MAC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1215255922
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4611 HARD SCRABBLE RD STE 109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29229-9499
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-350-9131
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6439 GARNERS FERRY RD
Provider Second Line Business Practice Location Address:
COLUMBIA
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29209-1638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-776-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  9291 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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