Provider Demographics
NPI:1962073957
Name:GEDDINGS, DAVID RANDALL (LISW-CP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RANDALL
Last Name:GEDDINGS
Suffix:
Gender:M
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 1:825 LOWCOUNTRY BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3064
Mailing Address - Country:US
Mailing Address - Phone:438-305-7005
Mailing Address - Fax:
Practice Address - Street 1:825 LOWCOUNTRY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3064
Practice Address - Country:US
Practice Address - Phone:438-305-7005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2025-05-22
Deactivation Date:2022-09-05
Deactivation Code:
Reactivation Date:2025-05-19
Provider Licenses
StateLicense IDTaxonomies
SC167081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical