Provider Demographics
NPI:1265855092
Name:FUHR, GEORGETTE THOMASINA (MSW, LCSW, LISW-CP)
Entity Type:Individual
Prefix:MRS
First Name:GEORGETTE
Middle Name:THOMASINA
Last Name:FUHR
Suffix:
Gender:F
Credentials:MSW, LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 INDIA HOOK RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-1278
Mailing Address - Country:US
Mailing Address - Phone:803-339-9504
Mailing Address - Fax:
Practice Address - Street 1:2424 INDIA HOOK RD STE 140
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1278
Practice Address - Country:US
Practice Address - Phone:803-339-9504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0110551041C0700X
SC134401041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical