Individual
NICOLE VENTOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW-CP/S
Contact information
Practice address
502 W MEETING ST, LANCASTER, SC 29720-2324
(803) 639-7700
Mailing address
502 W BARR ST, LANCASTER, SC 29720-1950
(917) 379-4989
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
9446
SC
1041C0700X
Clinical Social Worker
Primary
C008093
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1095
—
SC
Enumeration date
06/22/2012
Last updated
09/20/2016
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