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Individual

MR. JACK WILSON RHYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, LISW

Contact information

Practice address
812 STATE RD, CHERAW, SC 29520
(843) 537-0961
(843) 537-0908
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
(843) 857-0111
(843) 857-0206

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004880
SC
1041C0700X
Clinical Social Worker
C002180
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1255Y
BCBS
NC
05
405127
SC
05
SW1107
SC
Enumeration date
01/20/2006
Last updated
03/19/2024
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