Ellen Wallace Mabe, | |
812 State Rd, Cheraw, SC 29520-7113 | |
(843) 537-0961 | |
(843) 537-0908 |
Full Name | Ellen Wallace Mabe |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 812 State Rd, Cheraw, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659785954 | NPI | - | NPPES |
LW1023 | Medicaid | SC | |
SCS392 | Other | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 10797 (South Carolina) | Primary |
Entity Name | Caresouth Carolina Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280 |
Entity Name | Sc House Calls Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518048859 PECOS PAC ID: 6800994807 Enrollment ID: O20070613000821 |
Mailing Address | Practice Location Address |
---|---|
Ellen Wallace Mabe, Po Box 1090, Hartsville, SC 29551-1090 Ph: (843) 857-0111 | Ellen Wallace Mabe, 812 State Rd, Cheraw, SC 29520-7113 Ph: (843) 537-0961 |
Lisa Gleason, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 212 3rd St, Cheraw, SC 29520 Phone: 843-537-0961 | |
Mr. Jack Wilson Rhyne, LCSW, LISW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 812 State Rd, Cheraw, SC 29520 Phone: 843-537-0961 Fax: 843-537-0908 |