Provider Demographics
NPI:1851493159
Name:KARLSON, SANDRA W (LISW-CP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:W
Last Name:KARLSON
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 1:454 ANDERSON RD S
Mailing Address - Street 2:BTC 598, SUITE 2
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-3392
Mailing Address - Country:US
Mailing Address - Phone:803-351-7688
Mailing Address - Fax:877-752-1347
Practice Address - Street 1:454 ANDERSON RD S
Practice Address - Street 2:BTC 598, SUITE 2
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3392
Practice Address - Country:US
Practice Address - Phone:803-351-7688
Practice Address - Fax:877-752-1347
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC87481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ34380Medicare PIN