Provider Demographics
NPI:1437220522
Name:ORMAND, TERESA GREGORY (LISW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:GREGORY
Last Name:ORMAND
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WILLIAMS ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-2404
Mailing Address - Country:US
Mailing Address - Phone:803-287-4771
Mailing Address - Fax:803-328-3060
Practice Address - Street 1:114 WILLIAMS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2404
Practice Address - Country:US
Practice Address - Phone:803-287-4771
Practice Address - Fax:803-283-0603
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC82721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCE3134OtherMEDCOST
SC570629234006OtherBCBS
SCCJ5560OtherRAILROAD MEDICARE
SC570629234003OtherBCBS
SC570629234006OtherBCBS