Provider Demographics
NPI:1811204449
Name:MCFADDEN, JOAN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2741
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-2741
Mailing Address - Country:US
Mailing Address - Phone:803-708-4712
Mailing Address - Fax:803-708-4718
Practice Address - Street 1:2018 TAYLOR ST
Practice Address - Street 2:SUITE E
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1006
Practice Address - Country:US
Practice Address - Phone:803-708-4712
Practice Address - Fax:803-708-4718
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker