Individual
THAIS DEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2462 WINDMILL WAY, MYRTLE BEACH, SC 29579-3534
(908) 370-4650
Mailing address
505 AZOLLA WAY, STAFFORD, VA 22554-6883
(908) 370-4650
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10920
SC
1041C0700X
Clinical Social Worker
0904016221
VA
1041C0700X
Clinical Social Worker
Primary
13734
SC
Other
Enumeration date
05/27/2016
Last updated
02/20/2026
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