Provider Demographics
NPI:1326355181
Name:GANT, BEDELIA BURCHETTE (MSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:BEDELIA
Middle Name:BURCHETTE
Last Name:GANT
Suffix:
Gender:F
Credentials:MSW, LISW-CP
Other - Prefix:
Other - First Name:BEDELIA
Other - Middle Name:BURCHETTE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW-CP
Mailing Address - Street 1:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-1866
Mailing Address - Country:US
Mailing Address - Phone:843-421-5848
Mailing Address - Fax:
Practice Address - Street 1:10080 OCEAN HWY UNIT 8
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-5898
Practice Address - Country:US
Practice Address - Phone:843-421-5848
Practice Address - Fax:843-492-4154
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC94011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical