Provider Demographics
NPI:1245399278
Name:KRAININ, MARY SHEAHAN (MSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:SHEAHAN
Last Name:KRAININ
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 1:604 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5223
Mailing Address - Country:US
Mailing Address - Phone:843-629-0034
Mailing Address - Fax:
Practice Address - Street 1:604 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5223
Practice Address - Country:US
Practice Address - Phone:843-629-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5424104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC470458OtherVALUE OPTIONS ID #