Provider Demographics
NPI:1629568472
Name:MABLE, RENEA CHRISTINE (LISW-CP)
Entity Type:Individual
Prefix:
First Name:RENEA
Middle Name:CHRISTINE
Last Name:MABLE
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:RENEA
Other - Middle Name:CHRISTINE
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:419 FIREBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-7639
Mailing Address - Country:US
Mailing Address - Phone:803-429-9065
Mailing Address - Fax:
Practice Address - Street 1:719 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3432
Practice Address - Country:US
Practice Address - Phone:803-609-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical