Provider Demographics
NPI:1457137481
Name:SCARBROUGH, MAYA (LMSW)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:SCARBROUGH
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 1:454 ANDERSON RD S STE 214
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-3398
Mailing Address - Country:US
Mailing Address - Phone:704-625-6901
Mailing Address - Fax:
Practice Address - Street 1:454 ANDERSON RD S STE 214
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3398
Practice Address - Country:US
Practice Address - Phone:704-625-6901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16314104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker