Provider Demographics
NPI:1154461333
Name:CLARDY, SARAH WILSON (MSW)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:WILSON
Last Name:CLARDY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1909
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-1909
Mailing Address - Country:US
Mailing Address - Phone:843-421-4631
Mailing Address - Fax:
Practice Address - Street 1:20 POWDERHORN ROAD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681
Practice Address - Country:US
Practice Address - Phone:864-963-3421
Practice Address - Fax:864-962-0758
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health