| Mrs Tracey S Brannon, LISW-CP | |
|
129 Nursery Dr, Roebuck, SC 29376-2725 | |
| (864) 621-0955 | |
| Not Available |
| Full Name | Mrs Tracey S Brannon |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 129 Nursery Dr, Roebuck, 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 |
|---|---|---|---|
| 1518535426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6318 (South Carolina) | Primary |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194710426 PECOS PAC ID: 8022928001 Enrollment ID: O20050127000120 |
| Entity Name | Lifesource Of North Carolina |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972861789 PECOS PAC ID: 7416132428 Enrollment ID: O20120801000901 |
| Entity Name | Regenesis Organization Community Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982248852 PECOS PAC ID: 8022928001 Enrollment ID: O20210120001241 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tracey S Brannon, LISW-CP 129 Nursery Dr, Roebuck, SC 29376-2725 Ph: (864) 621-0955 | Mrs Tracey S Brannon, LISW-CP 129 Nursery Dr, Roebuck, SC 29376-2725 Ph: (864) 621-0955 |
Ms. Katharine D Brophy, LISW-CP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 170 Freedom Trl, Roebuck, SC 29376 Phone: 864-576-3744 | |
Mr. Terance Miles Dawkins, LISW-CP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 512 Dragonfly Ct, Roebuck, SC 29376 Phone: 864-621-9148 |