Provider Demographics
NPI:1477762623
Name:HEMPHILL, JANE R (LISW-CP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:R
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONCKTON BLVD STE 100B
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-4708
Mailing Address - Country:US
Mailing Address - Phone:803-828-9893
Mailing Address - Fax:803-828-3896
Practice Address - Street 1:125 ALPINE CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6385
Practice Address - Country:US
Practice Address - Phone:803-779-3548
Practice Address - Fax:803-779-7055
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10431041C0700X
SCSCB SWE 10431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5729Medicare ID - Type UnspecifiedGROUP #