Provider Demographics
NPI:1457890170
Name:MCEACHERN, SUSAN G (LCSW,LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:MCEACHERN
Suffix:
Gender:F
Credentials:LCSW,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-7423
Mailing Address - Country:US
Mailing Address - Phone:910-628-9091
Mailing Address - Fax:910-628-9092
Practice Address - Street 1:510 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-7423
Practice Address - Country:US
Practice Address - Phone:910-628-9091
Practice Address - Fax:910-628-9092
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0016921041C0700X
SC12221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical