Provider Demographics
NPI:1609927573
Name:GIRAUD, JUANITA A (LISW-CP)
Entity Type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:A
Last Name:GIRAUD
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 1:770 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4748
Mailing Address - Country:US
Mailing Address - Phone:803-773-2088
Mailing Address - Fax:803-773-7774
Practice Address - Street 1:770 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4748
Practice Address - Country:US
Practice Address - Phone:803-773-2088
Practice Address - Fax:803-773-7774
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC58531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7290Medicare UPIN