Provider Demographics
NPI:1922253905
Name:MCGUIRE, SARAH BRADLEY (LISW-CP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:BRADLEY
Last Name:MCGUIRE
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 1:2607 WOODRUFF RD
Mailing Address - Street 2:SUITE E-424
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4803
Mailing Address - Country:US
Mailing Address - Phone:864-918-3092
Mailing Address - Fax:
Practice Address - Street 1:250 S PLEASANTBURG DR
Practice Address - Street 2:#125
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2522
Practice Address - Country:US
Practice Address - Phone:864-918-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8696104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker