Provider Demographics
NPI:1376205112
Name:PUSEY, MARJORIE NIX
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:NIX
Last Name:PUSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 SOLANDRA WAY
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8804
Mailing Address - Country:US
Mailing Address - Phone:803-417-8248
Mailing Address - Fax:
Practice Address - Street 1:2212 WHITES RD
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-7687
Practice Address - Country:US
Practice Address - Phone:803-417-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2941101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty