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Organization

KERSHAW COUNTY SCHOOL DISTRICT

Active
Other names
Kershaw County Schools RBHS
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALISA GOODMAN PH.D (DIRECTOR FOR INSTRUCTIONAL SUPPORT)
(803) 432-8416
Entity
Organization

Contact information

Practice address
1109 CAMPBELL ST, CAMDEN, SC 29020-3507
(803) 425-7712
(803) 425-7713
Mailing address
2029 W DEKALB ST, CAMDEN, SC 29020-2093
(803) 432-8416
(803) 425-8918

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
101YS0200X
School Counselor
Primary
103T00000X
Psychologist
422
SC
103TC0700X
Clinical Psychologist
103TC1900X
Counseling Psychologist
422
SC
103TS0200X
School Psychologist
422
SC
1041S0200X
School Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2800
SC
Enumeration date
09/10/2014
Last updated
09/10/2014
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