Provider Demographics
NPI:1376696625
Name:BESS, DELORES (MA)
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:
Last Name:BESS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DELORES
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 N PIKE W
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29153-1906
Mailing Address - Country:US
Mailing Address - Phone:803-934-4087
Mailing Address - Fax:864-241-1124
Practice Address - Street 1:801 N PIKE W
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29153-1906
Practice Address - Country:US
Practice Address - Phone:803-934-4087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC405127Medicaid
SC3343Medicare PIN