Provider Demographics
NPI:1558790980
Name:WORKMAN, TROY (CAC I)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:CAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-3720
Mailing Address - Country:US
Mailing Address - Phone:803-726-9456
Mailing Address - Fax:806-726-9403
Practice Address - Street 1:1068 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-3720
Practice Address - Country:US
Practice Address - Phone:803-726-9456
Practice Address - Fax:806-726-9403
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13070816101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)