Provider Demographics
NPI:1609957489
Name:MARSDEN, BONNIE CHRISTMUS (LISW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:CHRISTMUS
Last Name:MARSDEN
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 1:4122 CLEMSON BLVD
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1100
Mailing Address - Country:US
Mailing Address - Phone:864-221-3565
Mailing Address - Fax:
Practice Address - Street 1:4122 CLEMSON BLVD
Practice Address - Street 2:SUITE 1-C
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1100
Practice Address - Country:US
Practice Address - Phone:864-221-3565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional