Provider Demographics
NPI:1932582244
Name:LAYTON, MIRANDA PARSONS (LCSW-C, LISW-CP)
Entity Type:Individual
Prefix:
First Name:MIRANDA
Middle Name:PARSONS
Last Name:LAYTON
Suffix:
Gender:F
Credentials:LCSW-C, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3964 MAIDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7577
Mailing Address - Country:US
Mailing Address - Phone:443-902-1836
Mailing Address - Fax:
Practice Address - Street 1:3964 MAIDSTONE DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7577
Practice Address - Country:US
Practice Address - Phone:443-902-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical