Provider Demographics
NPI:1952851347
Name:MOVSKY, SHANDI (LMSW)
Entity Type:Individual
Prefix:
First Name:SHANDI
Middle Name:
Last Name:MOVSKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 WACCAMAW MEDICAL PARK DRIVE
Mailing Address - Street 2:WACCAMAW CENTER FOR MENTAL HEALTH
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526
Mailing Address - Country:US
Mailing Address - Phone:843-347-5060
Mailing Address - Fax:843-347-3959
Practice Address - Street 1:164 WACCAMAW MEDICAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526
Practice Address - Country:US
Practice Address - Phone:843-347-5060
Practice Address - Fax:843-347-3959
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11387104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker