Provider Demographics
NPI:1841249547
Name:ROWLAND, HERBERT RUSSELL (M A)
Entity type:Individual
Prefix:
First Name:HERBERT
Middle Name:RUSSELL
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:M A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CLEMATIS TRL
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-2310
Mailing Address - Country:US
Mailing Address - Phone:803-469-3204
Mailing Address - Fax:
Practice Address - Street 1:533 OXFORD ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-3353
Practice Address - Country:US
Practice Address - Phone:803-236-3811
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2631101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional