Provider Demographics
NPI:1801932231
Name:BEAVER, NANCY CHAMBERS (LISW-CP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:CHAMBERS
Last Name:BEAVER
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 RICHLAND ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2635
Mailing Address - Country:US
Mailing Address - Phone:803-254-5650
Mailing Address - Fax:803-254-0012
Practice Address - Street 1:1703 RICHLAND ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2635
Practice Address - Country:US
Practice Address - Phone:803-254-5650
Practice Address - Fax:803-254-0012
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical