Provider Demographics
NPI:1396830717
Name:CARRIGAN, ASHTON M (MSW)
Entity Type:Individual
Prefix:MR
First Name:ASHTON
Middle Name:M
Last Name:CARRIGAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MEDICAL CIRCLE
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3656
Mailing Address - Country:US
Mailing Address - Phone:803-796-6811
Mailing Address - Fax:803-796-6851
Practice Address - Street 1:160 MEDICAL CIRCLE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3656
Practice Address - Country:US
Practice Address - Phone:803-796-6811
Practice Address - Fax:803-796-6851
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPRV49241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ31683Medicare UPIN