Provider Demographics
NPI:1255432340
Name:PADGETT, DAPHINE G
Entity type:Individual
Prefix:MRS
First Name:DAPHINE
Middle Name:G
Last Name:PADGETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:DAPHINE G
Other - Last Name:PADGETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1547 PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4081
Mailing Address - Country:US
Mailing Address - Phone:864-229-7120
Mailing Address - Fax:864-229-5526
Practice Address - Street 1:206 TRAVIS AVE
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-1224
Practice Address - Country:US
Practice Address - Phone:864-445-8122
Practice Address - Fax:864-445-9546
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC421504Medicaid
SC3340Medicare ID - Type Unspecified