Basic Information
| Provider Information | |||||||||
| NPI: | 1992759682 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCFADDEN | ||||||||
| FirstName: | RODERICK | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 N. MAGNOLIA ST. | ||||||||
| Address2: | SWCMHC | ||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291511946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037759364 | ||||||||
| FaxNumber: | 8037736615 | ||||||||
| Practice Location | |||||||||
| Address1: | 2611 LIBERTY HILL RD. | ||||||||
| Address2: | SWCMHC/KERSHAW CMHC, | ||||||||
| City: | CAMDEN | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034325323 | ||||||||
| FaxNumber: | 8037133978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.