Provider Demographics
NPI:1114357589
Name:MARY SHEAHAN KRAININ, MSW, LISW-CP
Entity Type:Organization
Organization Name:MARY SHEAHAN KRAININ, MSW, LISW-CP
Other - Org Name:EATING DISORDER CENTER OF THE PEE DEE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:SHEAHAN
Authorized Official - Last Name:KRAININ
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-CP
Authorized Official - Phone:843-319-1310
Mailing Address - Street 1:517 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5220
Mailing Address - Country:US
Mailing Address - Phone:843-319-1310
Mailing Address - Fax:
Practice Address - Street 1:517 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5220
Practice Address - Country:US
Practice Address - Phone:843-319-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty