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SHAIDA BLACKMON LEMOIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
200 PATEWOOD DR STE A100, GREENVILLE, SC 29615-6302
(864) 454-5612
(864) 454-5121
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
10808
SC
1041C0700X
Clinical Social Worker
Primary
10808
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SW1754
SC
Enumeration date
05/04/2015
Last updated
12/21/2022
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