# ANDERSON DISTRICT 4

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508102328
- **Authorized official:** MR. THOMAS WAYNE GOODWIN LPES (DIRECTOR OF SPECIAL EDUCATION)
- **Authorized official phone:** (864) 403-2000

## Contact information

- **Practice address:** 315 E QUEEN ST, PENDLETON, SC 29670-1721
- **Practice address phone:** (864) 403-2000
- **Practice address fax:** (864) 403-2099
- **Mailing address:** 315 E QUEEN ST, PENDLETON, SC 29670-1721
- **Mailing address phone:** (864) 403-2000
- **Mailing address fax:** (864) 403-2099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TS0200X | School Psychologist | 3046 | SC | Yes |

## Other

- **Enumeration date:** 12/26/2012
- **Last updated:** 12/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | SD0404 | — | SC |