| 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 |