Organization
DEPARTMENT OF JUVENILE JUSTICE
Active
Other names
South Carolina State Government
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH BENNETT-YORK LISW-CP, BCD (SOCIAL WORKER)
(803) 788-8911
Entity
Organization
Contact information
Practice address
1725 SHIVERS RD, COLUMBIA, SC 29210-5413
(806) 896-5695
Mailing address
11 BRADFORD KNOLL CT, COLUMBIA, SC 29223-7142
(803) 788-8911
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4663
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29832
AMERICAN BOARD OF EXAMINERS OF CLINICAL SOCIAL WORKERS
SC
01
—
4663
LICENSED BY THE BOARD OF SOCIAL WORK EXAMINERS
SC
Enumeration date
11/28/2012
Last updated
12/03/2012
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