Provider Demographics
NPI:1295888089
Name:HARDWICKE, SUSAN ELIZABETH (LISW CP)
Entity type:Individual
Prefix:MISS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:HARDWICKE
Suffix:
Gender:F
Credentials:LISW CP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2418 DEVINE ST
Mailing Address - Street 2:STE 104
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205
Mailing Address - Country:US
Mailing Address - Phone:803-920-4491
Mailing Address - Fax:803-256-5020
Practice Address - Street 1:2418 DEVINE ST
Practice Address - Street 2:STE 104
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205
Practice Address - Country:US
Practice Address - Phone:803-920-4491
Practice Address - Fax:803-256-5020
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC55131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical